Provider Demographics
NPI:1225894496
Name:WANG, ALAN WENBUO
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:WENBUO
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 GOLF RD APT 207
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4862
Mailing Address - Country:US
Mailing Address - Phone:408-892-3118
Mailing Address - Fax:
Practice Address - Street 1:2580 GOLF RD APT 207
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4862
Practice Address - Country:US
Practice Address - Phone:408-892-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program