Individual
GRANT JUNTIAN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 SAN PABLO ST, LOS ANGELES, CA 90033-5313
(323) 442-7400
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-7400
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125067544
IL
207L00000X
Anesthesiology Physician
Primary
A161534
CA
Other
Enumeration date
06/19/2015
Last updated
08/06/2019
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