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General NPI Number Information
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NPI Number | 1659782605
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Entity Type | Organization
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Legal Business Name | HENRY WANG MEDICAL INC
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 289 WEST HUNTINGTON DRIVE SUITE 301
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City | ARCADIA
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State | CA
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Zip | 91007
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Country | US
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Telephone | 626-247-1192
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Fax | 626-247-1196
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Provider Business Mailing Address
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Address Line | 289 WEST HUNTINGTON DRIVE SUITE 301
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City | ARCADIA
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State | CA
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Zip | 91007
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Country | US
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Telephone | 626-247-1192
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Fax | 626-247-1196
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENRY WANG
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Credential | M. D.
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Telephone | 626-247-1192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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