MEDICARE: LUKE WANG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	7945	NE
2	208800000X	Urology Physician	A176098	CA
3	208800000X	Urology Physician	2024031946	MO

General Provider Information

NPI Number	:	1033630173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE WANG MD

Provider Business Mailing Address
First Line	:	PO BOX 232410
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92193-2410
Country	:	US
Telephone Number	:	800-926-8273
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 SOUTH GRAND BOULEVARD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-9000
Country	:	US
Telephone Number	:	314-257-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2017
Last Update Date	:	05/14/2025

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Directions to “ LUKE WANG MD” Practice Location

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