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General NPI Number Information
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NPI Number | 1891929931
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Entity Type | Individual
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Provider Name | JIAN-FENG WANG
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Gender | Male
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 31 COLUMBIA CLARIENT PATHOLOGY SERVICE
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City | ALISO VIEJO
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State | CA
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Zip | 92656-1460
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Country | US
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Telephone | 949-425-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 MCCHARLES DR
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City | TUSTIN
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State | CA
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Zip | 92782-1074
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Country | US
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Telephone | 781-863-0113
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 229771
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A117332
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 265294-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ME113849
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License Number State | FL
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