Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1053561316 |
---|---|
Provider Name | Lan Wang |
First Address | El Monte, CA 91731-3229 |
Second Address | El Monte, CA 91731-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2008 |
Last Update Date | 20/04/2018 |