Provider Demographics
NPI:1275982118
Name:MA, YING WANG
Entity Type:Individual
Prefix:
First Name:YING
Middle Name:WANG
Last Name:MA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6821 STOCKTON BLVD
Mailing Address - Street 2:#145
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2480
Mailing Address - Country:US
Mailing Address - Phone:916-393-2738
Mailing Address - Fax:
Practice Address - Street 1:6821 STOCKTON BLVD
Practice Address - Street 2:#145
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2480
Practice Address - Country:US
Practice Address - Phone:916-393-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 15114171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist