MEDICARE: DR. LULU WEN-LUH 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
1	208000000X	Pediatrics Physician	A95467	CA

General Provider Information

NPI Number	:	1760656177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LULU WEN-LUH WANG M.D.

Provider Business Mailing Address
First Line	:	1520 RODNEY DR APT 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 RODNEY DR APT 215
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5325
Country	:	US
Telephone Number	:	323-361-2450
Fax Number	:

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

Provider Enumeration Date	:	04/16/2008
Last Update Date	:	04/16/2008

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