Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Glenn Kham Wakam, MD

Individual provider Surgery Physician · NPI 1972952422

Dr. Glenn Kham Wakam, MD is a General Surgery in San Diego, California. Graduated from University of California, San Francisco School of Medicine in 2016, 10 years ago. Practices with Regents of the University of California, a 2,061-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California and Michigan.

Years since qualifying
10
Trained at
University of California, San Francisco School of Medicine
Licensed in
CA, MI
In the registry since
2016
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4510 Executive Dr
San Diego, CA 92121-3021
Phone: (800) 926-8273
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 9300 Campus Point Dr, La Jolla, CA 92037-1300 — (800) 926-8273
  • 3020 Childrens Way, San Diego, CA 92123-4223 — (858) 576-1700

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence A203171 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 4301117353 (MI)

Record details

NPI number1972952422
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 6, 2016
Last updated in NPPESSeptember 5, 2025
Certification dateSeptember 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Regents Of The University Of California — 2061 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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