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General NPI Number Information
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NPI Number | 1548305683
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Entity Type | Individual
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Provider Name | BAOHUA WANG M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1711 W TEMPLE ST SUITE 7607
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City | LOS ANGELES
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State | CA
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Zip | 90026-5421
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Country | US
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Telephone | 213-413-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 8 OAKMONT DR
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City | LOS ANGELES
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State | CA
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Zip | 90049-1902
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Country | US
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Telephone | 310-666-0195
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A89750
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License Number State | CA
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