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General NPI Number Information
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NPI Number | 1205173895
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Entity Type | Individual
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Provider Name | KENNETH WANG MD , DO
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Gender | Male
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 88 SONG GAO ROAD 11F-2
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City | TAIPEI
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State | TAIWAN
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Zip | 110
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Country | TW
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Telephone | 886937926710
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Fax |
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Provider Business Mailing Address
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Address Line | #88 SONG GAO ROAD 11F-2
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City | TAIPEI
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State | TAIWAN
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Zip | 110
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Country | TW
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Telephone | 886937926710
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A8688
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License Number State | CA
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