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NPI Code Detail

MEDICARE: DR. PING WANG

MEDICARE: DR. PING 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
1171100000XAcupuncturistAC16096CA

General Provider Information

NPI Number : 1912402751
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PING WANG
Provider Business Mailing Address
First Line : PO BOX 643245
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-8458
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2812 SANTA MONICA BLVD STE 208
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2432
Country : US
Telephone Number : 818-659-5866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2018
Last Update Date : 06/11/2019

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