Provider Demographics
NPI:1417248097
Name:WANG, DORIS D (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:D
Last Name:WANG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE, ROOM M779
Mailing Address - Street 2:UCSF DEPARTMENT OF NEUROSURGERY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0112
Mailing Address - Country:US
Mailing Address - Phone:415-353-3904
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE, ROOM M779
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-3904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program