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General NPI Number Information
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NPI Number | 1437628443
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Entity Type | Organization
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Legal Business Name | YEN TUN WANG SERVICES MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 3810 MULTIVIEW DR
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City | LOS ANGELES
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State | CA
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Zip | 90068-1228
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Country | US
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Telephone | 347-738-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 3810 MULTIVIEW DR
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City | LOS ANGELES
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State | CA
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Zip | 90068-1228
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Country | US
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Telephone | 347-738-0603
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YEN TUN WANG
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Credential | MD
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Telephone | 585-354-5309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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