Doctor Name: | MR. TAISHINE WANG |
NPI Number: | 1841320595 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A42340 |
Business Practice Address: | 2713 Santa Ana Street South Gate, CA - 902802021 |
Business Phone Number: | 3235877275 |
Business Fax Number: | 3235879162 |
Mailing Address: | 2713 Santa Ana Street, SOUTH GATE |
State: | CA |
Postal Code: | 902802021 |
Phone Number: | 3235877275 |
Fax Number: | 3235879162 |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A42340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |