Organization
ROBERT T. WANG, PH.D., M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT T. WANG PH.D., M.D. (OWNER)
(323) 931-3100
Entity
Organization
Contact information
Practice address
5901 W OLYMPIC BLVD, SUITE 301, LOS ANGELES, CA 90036-4667
(323) 931-3100
(323) 931-0030
Mailing address
5901 W OLYMPIC BLVD, SUITE 301, LOS ANGELES, CA 90036-4667
(323) 931-3100
(323) 931-0030
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G40989
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9745630
—
CA
05
—
GR0079630
—
CA
Enumeration date
02/23/2007
Last updated
09/30/2011
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