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General NPI Number Information
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NPI Number | 1063788255
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Entity Type | Individual
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Provider Name | ANGELA L.F. WANG DO
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Gender | Female
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Dates
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Enumeration Date | 04/01/2012
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 9939 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92503-3528
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Country | US
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Telephone | 951-687-8802
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Fax | 951-687-2250
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Provider Business Mailing Address
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Address Line | PO BOX 70180
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City | RIVERSIDE
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State | CA
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Zip | 92513-0180
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Country | US
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Telephone | 951-354-3216
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Fax | 951-848-9968
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | OS13454
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20A15739
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License Number State | CA
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