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General NPI Number Information
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NPI Number | 1700055217
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Entity Type | Organization
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Legal Business Name | ALLAN WANG MD LLC
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 75-166 KALANI ST SUITE 204
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City | KAILUA KONA
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State | HI
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Zip | 96740-1857
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Country | US
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Telephone | 808-329-9264
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31000
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City | HONOLULU
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State | HI
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Zip | 96849-5516
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Country | US
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Telephone | 808-329-9264
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | DR. ALLAN VEH TUC WANG
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Credential | MD, PHD
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Telephone | 808-989-6543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 9287
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License Number State | HI
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