Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A124076 | CA |
NPI | 1235438482 |
---|---|
Provider Name | Dr. Dean Wang |
First Address | Orange, CA 92868-3201 |
Second Address | Orange, CA 92868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2011 |
Last Update Date | 28/08/2018 |