Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 4954 | HI |
NPI | 1134206329 |
---|---|
Provider Name | Dr. Victoria A Wang |
First Address | Honolulu, HI 96817-2364 |
Second Address | Honolulu, HI 96817-2364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01602601 | (05) | HI |
C05407 | (02) | HI |