Healthcare Provider Details

I. General information

NPI: 1457987430
Provider Name (Legal Business Name): EDWARD CHIA-HENG WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 CREEK RD
IRVINE CA
92604-4724
US

IV. Provider business mailing address

3080 BRISTOL ST STE 150
COSTA MESA CA
92626-3068
US

V. Phone/Fax

Practice location:
  • Phone: 714-445-0220
  • Fax:
Mailing address:
  • Phone: 714-445-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA184686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: