Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A162561 | CA |
Y | 208600000X | Surgeon | A162561 | CA |
NPI | 1013351865 |
---|---|
Provider Name | Dr. Eugene Wang |
First Address | Downey, CA 90242-2814 |
Second Address | Downey, CA 90242-2814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 03/11/2021 |