Individual
DONG WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
13315 W WASHINGTON BLVD, LOS ANGELES, CA 90066-5169
(310) 577-3000
Mailing address
12533 WALSH AVE, LOS ANGELES, CA 90066-6609
(512) 809-0610
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G51846995
PASSPORT
—
Enumeration date
09/21/2018
Last updated
09/21/2018
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