Healthcare Provider Details

I. General information

NPI: 1972842193
Provider Name (Legal Business Name): YUQI K WANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KEVIN YUQI WANG

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28881 AIROSO ST
RANCHO MISSION VIEJO CA
92694-2486
US

IV. Provider business mailing address

300 PASTEUR DR RM S031
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 805-456-6349
  • Fax:
Mailing address:
  • Phone: 650-725-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA167259
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: