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Physician Compare National (NPI:1275507857)

HEALTHCARE PROVIDER: ENOCH J. WANG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1275507857
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9638208903
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20100525000352
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name WANG
Individual professional last name
Provider First Name ENOCH
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 2000
Individual professional's medical school graduation year
Primary Specialty HOSPITALIST
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 INTERNAL MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties INTERNAL MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Line 1 Street Address 3109 CERROS REDONDOS
Group Practice or individual's line 1 address
City RANCHO SANTA FE
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 920672032
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 050324
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 SCRIPPS MEMORIAL HOSPITAL LA JOLLA
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 050424
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 SCRIPPS GREEN HOSPITAL
Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment Y

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