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NPI Code Detail

MEDICARE: LI WANG

MEDICARE: LI WANG
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
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1427717339
Entity Type Code : Individual
Provider Name (Legal Business Name) : LI WANG
Provider Business Mailing Address
First Line : 3230 POLARIS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8350
Country : US
Telephone Number : 702-678-5089
Fax Number :
Provider Business Practice Location Address
First Line : 3230 POLARIS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8350
Country : US
Telephone Number : 702-678-5089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2021
Last Update Date : 12/08/2021

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Directions to “ LI WANG ” Practice Location

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