Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A75686 | CA |
N | 208600000X | Surgeon | A75686 | CA |
Y | 2086S0129X | Vascular Surgeon | A75686 | CA |
NPI | 1023034568 |
---|---|
Provider Name | Dr. Wang Teng |
First Address | Laguna Hills, CA 92653-3651 |
Second Address | Laguna Hills, CA 92653-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 11/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I45146 | (02) | CA |