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General NPI Number Information
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NPI Number | 1699651422
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Entity Type | Organization
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Legal Business Name | FANG-RONG WANG MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 609 W LAS TUNAS DR
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1112
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Country | US
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Telephone | 626-289-2900
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Fax | 626-289-1722
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Provider Business Mailing Address
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Address Line | 609 W LAS TUNAS DR
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City | SAN GABRIEL
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State | CA
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Zip | 91776-1112
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Country | US
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Telephone | 626-289-2900
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Fax | 626-289-1722
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Authorized Official
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Title or Position | CREDENTIAL
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Name | NANCY TAN
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Credential |
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Telephone | 626-277-6022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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