Provider Demographics
NPI:1467499145
Name:WANG, WENG-LIH (MD)
Entity Type:Individual
Prefix:
First Name:WENG-LIH
Middle Name:
Last Name:WANG
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 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-8923
Practice Address - Street 1:36320 INLAND VALLEY DR
Practice Address - Street 2:SUITE 308
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-7512
Practice Address - Country:US
Practice Address - Phone:951-600-7630
Practice Address - Fax:951-600-7164
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48180207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A481800Medicaid
CA390004304OtherMEDICARE RAILROAD
CA390004304OtherMEDICARE RAILROAD
CABT814ZMedicare PIN