MEDICARE: GILBERT WHANG MD

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
1	2085B0100X	Body Imaging Physician	A94627	CA

General Provider Information

NPI Number	:	1326029398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILBERT WHANG MD

Provider Business Mailing Address
First Line	:	9998 CROSSPOINT BLVD STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3307
Country	:	US
Telephone Number	:	317-579-2150
Fax Number	:	317-579-2130

Provider Business Practice Location Address
First Line	:	1200 N STATE ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-1001
Country	:	US
Telephone Number	:	323-226-2622
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	05/28/2024

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