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NPI Code Detail

MEDICARE: DR. TIANYI WANG M.D.

MEDICARE: DR. TIANYI WANG M.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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianA122202CA

General Provider Information

NPI Number : 1639469349
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIANYI WANG M.D.
Provider Business Mailing Address
First Line : 2205 VISTA WAY STE 210
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-5661
Country : US
Telephone Number : 760-704-5750
Fax Number :
Provider Business Practice Location Address
First Line : 2205 VISTA WAY STE 210
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-5661
Country : US
Telephone Number : 760-704-5750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2011
Last Update Date : 01/08/2026

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