MEDICARE: JOHN C WANG D.O.

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	208800000X	Urology Physician	L3866	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	340020371	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8G4510	OTHER	TX	BLUECROSS/BLUESHIELD
3	10006843	OTHER	TX	AMERIGROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	7430373	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1154384352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C WANG D.O.

Provider Business Mailing Address
First Line	:	PO BOX 3067
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95992-3067
Country	:	US
Telephone Number	:	530-751-4784
Fax Number	:	530-751-4906

Provider Business Practice Location Address
First Line	:	370 DEL NORTE AVE
Second Line	:	SUITE 201
City	:	YUBA CITY
State	:	CA
Zip	:	95991-4142
Country	:	US
Telephone Number	:	530-674-8031
Fax Number	:	530-751-4158

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	01/22/2016

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Directions to “ JOHN C WANG D.O.” Practice Location

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