Individual
JOHN WING FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(657) 201-7771
Mailing address
101 THE CITY DR S, ORANGE, CA 92868-3201
(657) 201-7771
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A108413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL1765
NV MEDICAL LIC
NV
Enumeration date
07/10/2007
Last updated
07/03/2013
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