Healthcare Provider Details

I. General information

NPI: 1487999322
Provider Name (Legal Business Name): SHINSHAN WANG N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 S GARFIELD AVE STE 303
ALHAMBRA CA
91801-4430
US

IV. Provider business mailing address

723 S GARFIELD AVE STE 303
ALHAMBRA CA
91801-4430
US

V. Phone/Fax

Practice location:
  • Phone: 626-808-4365
  • Fax: 855-802-6293
Mailing address:
  • Phone: 626-808-4365
  • Fax: 855-802-6293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-558
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: