Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A174739 | CA |
N | 207XS0106X | Orthopaedic Hand Surgeon | A174739 | CA |
Y | 2086S0105X | Surgery of the Hand | A174739 | CA |
NPI | 1255727285 |
---|---|
Provider Name | Dr. Joanne Helen Wang |
First Address | Ventura, CA 93003-7844 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2015 |
Last Update Date | 06/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A174739 | STATE LICENSE (01) | CA |