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General NPI Number Information
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NPI Number | 1912402751
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Entity Type | Individual
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Provider Name | DR. PING WANG
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 2812 SANTA MONICA BLVD STE 208
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City | SANTA MONICA
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State | CA
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Zip | 90404-2432
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Country | US
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Telephone | 818-659-5866
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 643245
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City | LOS ANGELES
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State | CA
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Zip | 90064-8458
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC16096
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License Number State | CA
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