Provider Demographics
NPI:1063451243
Name:ZHANG, WENGANG (MD)
Entity Type:Individual
Prefix:
First Name:WENGANG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 GLADSTONE DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5123
Mailing Address - Country:US
Mailing Address - Phone:925-432-3318
Mailing Address - Fax:925-432-4590
Practice Address - Street 1:2220 GLADSTONE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5123
Practice Address - Country:US
Practice Address - Phone:925-432-3318
Practice Address - Fax:925-432-4590
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA65147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A651470Medicaid
CA00A651473Medicare PIN
CA00A651470Medicaid