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NPI Code Detail

MEDICARE: SHIYU WANG DDS

MEDICARE:   SHIYU  WANG  DDS
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
11223G0001XGeneral Practice Dentistry50693CA

General Provider Information

NPI Number : 1588730576
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIYU WANG DDS
Provider Business Mailing Address
First Line : 3022 INTERNATIONAL BLVD STE 503
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2227
Country : US
Telephone Number : 510-534-7600
Fax Number : 510-534-1407
Provider Business Practice Location Address
First Line : 3022 INTERNATIONAL BLVD STE 503
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2227
Country : US
Telephone Number : 510-534-7600
Fax Number : 510-534-1407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 07/08/2007

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Directions to “ SHIYU WANG DDS” Practice Location

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