Provider Demographics
NPI:1467103051
Name:YI WANG MD, LLC
Entity Type:Organization
Organization Name:YI WANG MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-841-2452
Mailing Address - Street 1:1315 WALNUT ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4717
Mailing Address - Country:US
Mailing Address - Phone:484-841-2452
Mailing Address - Fax:541-229-1243
Practice Address - Street 1:1315 WALNUT ST STE 1700
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4717
Practice Address - Country:US
Practice Address - Phone:484-841-2452
Practice Address - Fax:541-229-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health