Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A118139 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A118139 | CA |
NPI | 1275767956 |
---|---|
Provider Name | Zhinian Wan |
First Address | Artesia, NM 88210-1199 |
Second Address | Artesia, NM 88210-1133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 21/06/2021 |