| Doctor Name: | SU WANG |
| NPI Number: | 1699924894 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, DPT, OCS, CSCS |
| License Number: | PT34847 |
| Business Practice Address: | 1500 Adams Ave Ste 104a Costa Mesa, CA - 926263866 |
| Business Phone Number: | 6576008320 |
| Business Fax Number: | 6576008318 |
| Mailing Address: | 1500 Adams Ave, Ste 104a COSTA MESA |
| State: | CA |
| Postal Code: | 926263866 |
| Phone Number: | 6576008320 |
| Fax Number: | 6576008318 |
| NPI Enumeration Date: | 09/11/2008 |
| NPI Last Update Date: | 02/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT34847 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |