Healthcare Provider Details

I. General information

NPI: 1467369413
Provider Name (Legal Business Name): HUAN WANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9406 WASHINGTON BLVD
PICO RIVERA CA
90660-3913
US

IV. Provider business mailing address

2040 CAMFIELD AVE
COMMERCE CA
90040-1574
US

V. Phone/Fax

Practice location:
  • Phone: 888-499-9303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95041258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: