Healthcare Provider Details

I. General information

NPI: 1134707805
Provider Name (Legal Business Name): SVEN ZHOU WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SVEN ZHOU

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 CLARK AVE UNIT A
LONG BEACH CA
90815-2521
US

IV. Provider business mailing address

2220 CLARK AVE UNIT A
LONG BEACH CA
90815-2521
US

V. Phone/Fax

Practice location:
  • Phone: 562-997-7888
  • Fax:
Mailing address:
  • Phone: 562-997-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036.169100
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.077756
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberA209555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: