Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 1506 | OR |
Y | 175F00000X | Naturopath | ND40 | CA |
NPI | 1114125580 |
---|---|
Provider Name | Dr. Suzann Wang |
First Address | Los Altos, CA 94022-1534 |
Second Address | Los Altos, CA 94022-1534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 14/08/2014 |