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Individual

MARILENE BETH WANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
200 MEDICAL PLAZA, #550, LOS ANGELES, CA 90095
(310) 206-6688
(310) 206-4105
Mailing address
5767 W CENTURY BLVD, SUITE # 200, LOS ANGELES, CA 90045-5632
(310) 206-6688
(310) 206-4105

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G60942
CA
207YS0012X
Sleep Medicine (Otolaryngology) Physician
G60942
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G609420
CA
Enumeration date
08/16/2006
Last updated
04/10/2012
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