Organization
WILSHIRE DISTRICT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIMON JIANG M.D. (CEO)
(213) 384-5132
Entity
Organization
Contact information
Practice address
1314 WILSHIRE BLVD., LOS ANGELES, CA 90017-1705
(213) 384-5132
(213) 234-4542
Mailing address
13521 TELEGRAPH RD STE B, WHITTIER, CA 90605-3462
(562) 946-7571
(213) 234-4542
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A69991
CA
208D00000X
General Practice Physician
Primary
A69991
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A699910
—
CA
Enumeration date
08/15/2006
Last updated
10/03/2017
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