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General NPI Number Information
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NPI Number | 1194905323
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Entity Type | Organization
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Legal Business Name | DANIEL Y WANG MD CORP
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 920 SUNNYSLOPE RD
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City | HOLLISTER
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State | CA
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Zip | 95023-5784
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Country | US
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Telephone | 831-636-1332
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Fax | 831-636-1342
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Provider Business Mailing Address
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Address Line | 920 SUNNYSLOPE RD
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City | HOLLISTER
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State | CA
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Zip | 95023-5784
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Country | US
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Telephone | 831-636-1332
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Fax | 831-636-1342
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL YU WANG
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Credential | MD
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Telephone | 831-636-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A96792
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License Number State | CA
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