Dejun Wang M.D. Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A71575 Issued in CA

Legal business name

DEJUN WANG M.D. INC

Practice address

19115 Colima Rd Unit 104
Rowland Heights, CA 91748-3074

Phone

(626) 810-2983

Fax

(626) 810-5741

NPI assigned

Mar 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dejun Wang, MD.NPI 1275559288

Title

President

Phone

(626) 810-2983

Specialties & licenses 1

Addresses

Other names 1

• Dejun Wang M D Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dejun Wang, M.D.

  • Internal Medicine Physician
  • Rowland Heights, CA
  • NPI 1275559288
  Medicare reassignment Authorized official
• Shuang Bai, M.D.

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1154346799
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1811211659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18391 COLIMA RD",
            "address_2": "204",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917482730",
            "telephone_number": "626-810-2983",
            "fax_number": "626-810-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 COLIMA RD UNIT 104",
            "city": "ROWLAND HEIGHTS",
            "state": "CA",
            "postal_code": "917483074",
            "telephone_number": "626-810-2983",
            "fax_number": "626-810-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEJUN WANG M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-23",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "DEJUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-810-2983",
        "authorized_official_credential": "MD."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A71575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dejun Wang M D Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Primary Care Clinic/Center in Rowland Heights, CA
• Providers in Rowland Heights, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.