MEDICARE: MRS. YANFANG WANG CAMTC

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	225700000X	Massage Therapist	57796	CA

General Provider Information

NPI Number	:	1912534488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YANFANG WANG CAMTC

Provider Business Mailing Address
First Line	:	6249 E MARINA VIEW DR
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-2320
Country	:	US
Telephone Number	:	562-547-4185
Fax Number	:

Provider Business Practice Location Address
First Line	:	8201 WESTMINSTER BLVD STE 100
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-3332
Country	:	US
Telephone Number	:	714-892-8039
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	03/25/2020

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