Individual
VIVIAN WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
757 WESTWOOD PLZ, SUITE 7501, LOS ANGELES, CA 90095-7417
(310) 825-7375
Mailing address
1131 N PACIFIC AVE, GLENDALE, CA 91202-2358
(310) 825-7375
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A141344
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2014
Last updated
02/19/2019
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