Individual
LINA WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST, SUITE 207, LOS ANGELES, CA 90033-5313
(323) 442-2582
(323) 442-2588
Mailing address
PO BOX 31309, LOS ANGELES, CA 90033-0309
(323) 442-2582
(323) 442-2588
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A64308
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A643080
BLUE SHIELD
CA
05
—
00A643080
—
CA
01
—
1952325565
GROUP NPI
CA
01
—
P00290174
MEDICARE RAILROAD
CA
Enumeration date
07/31/2006
Last updated
12/11/2013
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