Individual
KIM L WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3301 C ST, SUITE #200-E, SACRAMENTO, CA 95816-3300
(916) 447-6267
(916) 447-0621
Mailing address
3301 C ST, SUITE #200-E, SACRAMENTO, CA 95816-3300
(916) 447-6267
(916) 447-0621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A96087
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A96087
MEDICAL LICENSE NUMBER
CA
05
—
A96087
—
CA
01
—
BM269S
MEDICARE PTAN
CA
01
—
BM269T
MEDICARE PTAN
CA
01
—
BM269U
MEDICARE PTAN
CA
01
—
BM269V
MEDICARE PTAN
CA
01
—
BM269W
MEDICARE PTAN
CA
01
—
BM269X
MEDICARE PTAN
CA
01
—
BM269Y
MEDICARE PTAN
CA
01
—
BM269Z
MEDICARE PTAN
CA
Enumeration date
09/28/2006
Last updated
05/06/2009
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