Qiu Hua Wan, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A11475 Issued in CA

Practice address

400 N Pepper Ave
Internal Medicine Department
Colton, CA 92324-1801

Phone

(909) 580-1728

Fax

(909) 580-1727

NPI assigned

Nov 22, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Kansas City University of Physicians and Surgeons, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Galen Inpatient Physicians, PC

  • Hospitalist Physician
  • Manteca, CA
  • NPI 1689320459
  Medicare reassignment NPD
• Galen Inpatient Physicians Inc

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1215391594
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St. Joseph Hospital of Orange

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1861794968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NORTH PEPPER AVENUE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-1728",
            "fax_number": "909-580-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "INTERNAL MEDICINE DEPARTMENT",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1728",
            "fax_number": "909-580-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "QIU HUA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A11475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd Wall, CADC II
• Andrew Anthony Wallace Sr.
• Martin Walls
• Walmart Inc.
• Walton Dialysis LLC
• Ashley C Wang, MD
• Dennis Wang, P.A.
• Dongying Wang, DO
• Ming Yu Wang
• Ethel Wanyana

• Internal Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.