Healthcare Provider Details

I. General information

NPI: 1407932320
Provider Name (Legal Business Name): CHRISTINE WANG KORNU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE DE-TING WANG MD

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17877 VON KARMAN AVE STE 210
IRVINE CA
92614-4227
US

IV. Provider business mailing address

17877 VON KARMAN AVE STE 210
IRVINE CA
92614-4227
US

V. Phone/Fax

Practice location:
  • Phone: 949-617-2525
  • Fax: 949-617-3535
Mailing address:
  • Phone: 949-617-2525
  • Fax: 949-617-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA77521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: