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NPI Code Detail

MEDICARE: VICTORIA WANG MD

MEDICARE: VICTORIA 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
1207WX0120XCornea and External Diseases Specialist PhysicianDR.0077093CO
2390200000XStudent in an Organized Health Care Education/Training Program
3207W00000XOphthalmology PhysicianDR.0077093CO

General Provider Information

NPI Number : 1588304976
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA WANG MD
Provider Business Mailing Address
First Line : 2051 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1352
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2051 MARENGO ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-1352
Country : US
Telephone Number : 323-409-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2022
Last Update Date : 06/02/2026

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