Organization
JWANG MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER P WANG MD (PRESIDENT)
(650) 969-4600
Entity
Organization
Contact information
Practice address
525 SOUTH DRIVE, SUITE 219, MOUNTAIN VIEW, CA 94040
(650) 969-4600
(650) 969-1936
Mailing address
525 SOUTH DRIVE, SUITE 219, MOUNTAIN VIEW, CA 94040
(650) 969-4600
(650) 969-1936
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A76003
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07240150030
MEDICARE DMERC
CA
01
—
5999120001
MEDICARE PTAN
CA
01
—
5999120002
MEDICARE PTAN
CA
01
—
DG2282
MEDICARE RAILROAD
CA
01
—
P00423519
MEDICARE RR PTAN
CA
Enumeration date
09/22/2006
Last updated
07/08/2013
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