Individual
EVELYN WANGSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 W FAIRVIEW AVE, SAN GABRIEL, CA 91776-2959
(562) 293-8777
Mailing address
161 W FAIRVIEW AVE, SAN GABRIEL, CA 91776-2959
(562) 293-8777
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95004913
CA
Other
Enumeration date
09/03/2016
Last updated
02/17/2026
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