Provider Demographics
NPI:1477639771
Name:WANG, AGNES J (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:J
Last Name:WANG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:450 6TH AVE FL 4
Mailing Address - Street 2:KAISER PERMANENTE - DEPT OF UROLOGY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3010
Mailing Address - Country:US
Mailing Address - Phone:415-833-3239
Mailing Address - Fax:
Practice Address - Street 1:450 6TH AVE FL 4
Practice Address - Street 2:KAISER PERMANENTE - DEPT OF UROLOGY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3010
Practice Address - Country:US
Practice Address - Phone:415-833-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2021-12-20
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Provider Licenses
StateLicense IDTaxonomies
MO2005018372208800000X
NC2010-00543208800000X
CAA122837208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology