Individual
AI WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 SAINT ALBANS RD, SAN MARINO, CA 91108-1864
(951) 367-5640
Mailing address
1525 SAINT ALBANS RD, SAN MARINO, CA 91108-1864
(951) 367-5640
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
08/01/2017
Last updated
07/21/2022
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