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General NPI Number Information
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NPI Number | 1013578939
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Entity Type | Organization
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Legal Business Name | RYAN WANG MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 11878 AVENUE OF INDUSTRY
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City | SAN DIEGO
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State | CA
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Zip | 92128-3423
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Country | US
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Telephone | 858-925-7346
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Fax | 619-567-1011
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Provider Business Mailing Address
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Address Line | PO BOX 1770
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City | LA MESA
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State | CA
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Zip | 91944-1770
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Country | US
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Telephone | 858-925-7346
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Fax | 858-384-4849
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | RYAN Y WANG
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Credential | MD
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Telephone | 858-925-7346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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