Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | C146170 | CA |
NPI | 1104818590 |
---|---|
Provider Name | Qingping Wang |
First Address | South San Francisco, CA 94080-3208 |
Second Address | South San Francisco, CA 94080-3208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H31287 | (02) |