Healthcare Provider Details

I. General information

NPI: 1124373345
Provider Name (Legal Business Name): ZHIJUN WANG MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2012
Last Update Date: 07/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 ODYSSEY SUITE 105
IRVINE CA
92618-3186
US

IV. Provider business mailing address

22 ODYSSEY SUITE 105
IRVINE CA
92618-3186
US

V. Phone/Fax

Practice location:
  • Phone: 949-733-0988
  • Fax: 949-733-0972
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ZHIJUN WANG
Title or Position: DR.
Credential:
Phone: 949-733-0988