Individual
BRIAN WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1501 SUPERIOR AVE STE 205, NEWPORT BEACH, CA 92663-3640
(949) 642-4974
(949) 642-2647
Mailing address
1501 SUPERIOR AVE STE 205, NEWPORT BEACH, CA 92663-3640
(949) 642-4974
(949) 642-2647
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
20A16174
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A16174
LICENSE
CA
Enumeration date
03/22/2016
Last updated
03/07/2023
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