Individual
VICTOR SHERWIN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 E YORBA LINDA BLVD, #103 THE INTERNAL MEDICINE GROUP, PLACENTIA, CA 92870-3730
(714) 996-3700
Mailing address
PHR GROUP PROVIDER ENROLLMENT UNIT 3RD FL, 393 E WALNUT ST, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
227891
MA
207RG0100X
Gastroenterology Physician
Primary
A86616
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BL515
MEDICARE PTAN
CA
Enumeration date
07/10/2006
Last updated
11/29/2021
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