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NPI Code Detail

MEDICARE: LILLIAN WANG

MEDICARE: LILLIAN 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588507305
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIAN WANG
Provider Business Mailing Address
First Line : 44121 GLENDORA DR
Second Line :
City : FREMONT
State : CA
Zip : 94539-5939
Country : US
Telephone Number : 510-458-2350
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MAIN ST
Second Line :
City : FLUSHING
State : NY
Zip : 11355-5045
Country : US
Telephone Number : 718-670-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ LILLIAN WANG ” Practice Location

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