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

Theodore Thompson Wang

Individual provider Diagnostic Radiology Physician · NPI 1578199501

Theodore Thompson Wang is a Diagnostic Radiology in Los Angeles, California. Graduated from University of Southern California Keck School of Medicine in 2020, 6 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021
Phone: (833) 574-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 401 Bicentennial Way, Santa Rosa, CA 95403-2149 — (707) 393-4000

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence A181864 (CA)

Record details

NPI number1578199501
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 21, 2020
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 2025

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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