Individual
JACKSON WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10058 WOLF RD, GRASS VALLEY, CA 95949-8194
(530) 268-7708
Mailing address
10058 WOLF RD, GRASS VALLEY, CA 95949-8194
(530) 268-7708
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A119259
CA
Other
Enumeration date
11/28/2011
Last updated
05/19/2015
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