Organization
TRI-CITY GASTROENTEROLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHING ANGELA WANG MD (MEDICAL DOCTOR)
(928) 445-4066
Entity
Organization
Contact information
Practice address
5350 DISTINCTION WAY, PRESCOTT, AZ 86301-8418
(928) 445-4066
Mailing address
PO BOX 30444, FLAGSTAFF, AZ 86003-0444
(928) 266-0118
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0732200
BCBS
AZ
05
—
769789
—
AZ
Enumeration date
01/24/2019
Last updated
08/12/2019
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