Organization
CHUNG NAN WANG, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHUNG NAN WANG M.D. (OWNER)
(310) 471-5852
Entity
Organization
Contact information
Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5011
Mailing address
11999 SAN VICENTE BLVD, #440, LOS ANGELES, CA 90049-5131
(310) 471-5852
(310) 471-3958
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A31187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064530
—
CA
Enumeration date
07/18/2006
Last updated
08/22/2020
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