MICHAEL WAN M.D. INC NPI 1962755702

NPI Information

  • NPI: 1962755702
  • Provider Name: MICHAEL WAN, M.D., INC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 11100 WARNER AVE
    SUITE 150B
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Phone: (714) 546-6600

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NPI Details

MICHAEL WAN, M.D., INC is a medical specialty clinic center in Fountain Valley, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). MICHAEL WAN, M.D., INC NPI is 1962755702. The provider is registered as an organization entity type.

The provider's business location address is:

11100 WARNER AVE
SUITE 150B
FOUNTAIN VALLEY, CA
ZIP 92708-506
Phone: (714) 546-6600
Fax: (714) 546-6608

The provider's authorized official is Michael Wan .
The authorized official title is President and has the following contact phone number (714) 546-6600.

The enumeration date for this NPI number is 10/17/2012 and was last updated on 10/17/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyA36431CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A28086MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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