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General NPI Number Information
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NPI Number | 1255469433
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Entity Type | Individual
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Provider Name | HOWARD C WANG O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 7630 VIA CAMPANILE SUITE 134
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City | CARLSBAD
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State | CA
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Zip | 92009-8486
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Country | US
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Telephone | 760-613-9526
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Fax | 760-539-7202
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Provider Business Mailing Address
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Address Line | 648 WEATHERSTONE WAY
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City | SAN MARCOS
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State | CA
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Zip | 92078-1095
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Country | US
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Telephone | 760-613-9526
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Fax | 951-296-0342
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12673
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License Number State | CA
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