Individual provider Active NPI

Lillian Chen Wang, PA-C, CPH

  • Physician Assistant
  • Fountain Valley, CA
National Provider Identifier
1902383284
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055
Phone
(714) 850-7300
Fax
(714) 850-7310
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055

Mailing address

11160 Warner Ave Ste 311
Fountain Valley, CA 92708-4055
Phone (714) 850-7300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190123000602 CA Practitioner - Physician Assistant 4587901046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthcare Service Partners IncGroup PAC ID 0648557363, 10 clinicians

Practice addresses (Care Compare)

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (833) 477-2677

Hospital & facility affiliations

  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthowest Physician Assistant CurrentSince Dec 1, 2020 Accepting new patients
Physician Assistant Specialists-California Inc Physician Assistant PastSince Oct 8, 2023 Accepting new patients

Locations

11160 Warner Ave
Ste 311
Fountain Vly, CA 92708
Phone (714) 850-7300

22 Odyssey
Ste 205
Irvine, CA 92618
Phone (949) 870-3332

24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637
Phone (949) 767-0800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1902383284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055",
            "telephone_number": "714-850-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11160 WARNER AVE STE 311",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084055",
            "telephone_number": "714-850-7300",
            "fax_number": "714-850-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "LILLIAN",
        "middle_name": "CHEN",
        "credential": "PA-C, CPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-07-15",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.