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NPI Code Detail

MEDICARE: JAMES N WANG D.O.

MEDICARE: JAMES N WANG D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20A8055CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134163637
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES N WANG D.O.
Provider Business Mailing Address
First Line : 3301 N EASTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90032-1931
Country : US
Telephone Number : 323-225-2351
Fax Number : 323-225-7555
Provider Business Practice Location Address
First Line : 3301 N EASTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90032-1931
Country : US
Telephone Number : 323-225-2351
Fax Number : 323-225-7555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/16/2015

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