Organization
WILSHIRE DISTRICT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON JIANG M.D. (PRESIDENT)
(213) 458-3132
Entity
Organization
Contact information
Practice address
925 S ATLANTIC BLVD STE 106, MONTEREY PARK, CA 91754
(213) 458-3132
(213) 234-4542
Mailing address
13521 TELEGRAPH RD STE B, WHITTIER, CA 90605-3462
(562) 946-7571
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A69991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A699911
—
CA
Enumeration date
08/31/2007
Last updated
05/29/2018
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