Healthcare Provider Details

I. General information

NPI: 1790793289
Provider Name (Legal Business Name): MAY LI WANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11245 LOWER AZUSA RD
EL MONTE CA
91731
US

IV. Provider business mailing address

11245 LOWER AZUSA RD
EL MONTE CA
91731-1411
US

V. Phone/Fax

Practice location:
  • Phone: 626-579-9541
  • Fax: 626-579-9604
Mailing address:
  • Phone: 626-579-9541
  • Fax: 626-579-9604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA64130
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: