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General NPI Number Information
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NPI Number | 1215135496
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Entity Type | Individual
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Provider Name | XIU-JIE WANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 3660 PARK SIERRA DR SUITE 105
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City | RIVERSIDE
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State | CA
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Zip | 92505-3081
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Country | US
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Telephone | 951-278-8870
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Fax | 951-278-8913
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Provider Business Mailing Address
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Address Line | PO BOX 2828
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City | CORONA
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State | CA
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Zip | 92878-2828
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Country | US
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Telephone | 951-278-8870
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Fax | 951-278-8913
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD432218
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | C133870
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License Number State | CA
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