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General NPI Number Information
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NPI Number | 1578775334
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Entity Type | Individual
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Provider Name | NING WAN MS, RD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 700 WELCH RD RM MS 5891
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City | PALO ALTO
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State | CA
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Zip | 94304-1502
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Country | US
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Telephone | 650-497-8214
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Fax | 650-736-2130
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Provider Business Mailing Address
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Address Line | 12 SUTTER CREEK LN
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94043-3109
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Country | US
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Telephone |
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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 | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 896706
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License Number State | CA
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