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NPI Code Detail

MEDICARE: CHUNG KUN WANG DDS

MEDICARE:   CHUNG KUN  WANG  DDS
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
11223P0221XPediatric Dentistry38619CA

General Provider Information

NPI Number : 1881654481
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHUNG KUN WANG DDS
Provider Business Mailing Address
First Line : 1580 VALENCIA STREET,
Second Line : SUITE 605
City : SAN FRANCISCO
State : CA
Zip : 94110-4415
Country : US
Telephone Number : 415-648-5100
Fax Number : 415-648-9035
Provider Business Practice Location Address
First Line : 1580 VALENCIA ST
Second Line : SUITE 605
City : SAN FRANCISCO
State : CA
Zip : 94110-4423
Country : US
Telephone Number : 415-648-5100
Fax Number : 415-648-9035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 07/08/2007

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Directions to “ CHUNG KUN WANG DDS” Practice Location

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