Physician Compare National (NPI:1902820087)

HEALTHCARE PROVIDER: TIMOTHY T. WANG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1902820087
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587823513
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120312000552
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WANG
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2350 MCKEE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	SAN JOSE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	951161617
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4082722020
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050125
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	REGIONAL MEDICAL CENTER OF SAN JOSE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y