Healthcare Provider Details

I. General information

NPI: 1538253802
Provider Name (Legal Business Name): MICHAEL DONALD WANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6513 ATLANTIC AVE
BELL CA
90201-2521
US

IV. Provider business mailing address

6513 ATLANTIC AVE
BELL CA
90201-2521
US

V. Phone/Fax

Practice location:
  • Phone: 562-444-5450
  • Fax: 562-270-9738
Mailing address:
  • Phone: 562-444-5450
  • Fax: 562-270-9738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA70345
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA70345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: