Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 53044 | CA |
NPI | 1033374897 |
---|---|
Provider Name | Dr. Jen-Kuei Wang |
First Address | Sunnyvale, CA 94086-5325 |
Second Address | Sunnyvale, CA 94086-5325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2008 |
Last Update Date | 01/07/2009 |