Healthcare Provider Details

I. General information

NPI: 1003471467
Provider Name (Legal Business Name): JASON FENG WANG MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WEBSTER ST STE 509
OAKLAND CA
94609-3149
US

IV. Provider business mailing address

3300 WEBSTER ST STE 509
OAKLAND CA
94609-3149
US

V. Phone/Fax

Practice location:
  • Phone: 510-452-0330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA182416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: