Individual provider Active NPI

Sunnie Wang, M.D.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1851707343
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A141145 Issued in CA
Practice address
4462 Arch St
San Diego, CA 92116-1001
Phone
(858) 215-1010
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A141145 CA Primary

Addresses

Primary practice location

4462 Arch St
San Diego, CA 92116-1001

Mailing address

4928 Vista PL
San Diego, CA 92116-1429
Phone (858) 215-1010

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (619) 543-2165

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171212001451 CA Practitioner - Family Practice 0941593008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Mission St
Suite 800
San Francisco, CA 94105-1744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A141145CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Jun 1, 2023 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Cloud Health Medical Group of California, P.C. Family Medicine Past Accepting new patients

Locations

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

33758 Yucaipa Blvd
Yucaipa, CA 92399
Phone (909) 795-9747

Interoperability endpoints

  • Direct secure messaging: sunnie.wang.1@19957.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1851707343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4928 VISTA PL",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161429",
            "telephone_number": "858-215-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4462 ARCH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921161001",
            "telephone_number": "858-215-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "619-543-2165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "SUNNIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A141145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5601 De Soto Ave",
            "city": "Woodland Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913676701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.