MEDICARE: DR. EMILY KUO WANG O.D.

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	152W00000X	Optometrist	11164T	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1548258502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY KUO WANG O.D.

Provider Business Mailing Address
First Line	:	29 E. HUNTINGTON DR.
Second Line	:	STE. B
City	:	ARCADIA
State	:	CA
Zip	:	91006-3210
Country	:	US
Telephone Number	:	626-303-1888
Fax Number	:	626-821-9696

Provider Business Practice Location Address
First Line	:	29 E. HUNTINGTON DR.
Second Line	:	STE. B
City	:	ARCADIA
State	:	CA
Zip	:	91006-3210
Country	:	US
Telephone Number	:	626-303-1888
Fax Number	:	626-821-9696

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	03/23/2018

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