Organization
DR. NANCY WANG, OD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY WANG OD (OWNER)
(909) 982-9002
Entity
Organization
Contact information
Practice address
300 N EUCLID AVE STE A, UPLAND, CA 91786-6031
(909) 982-9002
(909) 982-9912
Mailing address
300 N EUCLID AVE STE A, UPLAND, CA 91786-6031
(909) 982-9002
(909) 982-9912
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
11233T
CA
332H00000X
Eyewear Supplier
11233T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP112333
MEDICARE
CA
05
—
SD0112330
—
CA
Enumeration date
10/19/2007
Last updated
02/29/2008
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