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NPI Code Detail

MEDICARE: DR. BENJAMIN Y WANG MD

MEDICARE: DR. BENJAMIN Y 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
12085R0202XDiagnostic Radiology PhysicianA60595CA
22085R0202XDiagnostic Radiology PhysicianK4604TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00995222OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932191590
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN Y WANG MD
Provider Business Mailing Address
First Line : PO BOX 2030
Second Line :
City : LOWELL
State : AR
Zip : 72745-2030
Country : US
Telephone Number : 855-381-9178
Fax Number : 913-234-1116
Provider Business Practice Location Address
First Line : 8750 WILSHIRE BLVD STE 100
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-2708
Country : US
Telephone Number : 310-689-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 12/10/2025

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