Provider Demographics
NPI:1518106665
Name:WANG CHIROPRACTIC
Entity Type:Organization
Organization Name:WANG CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:K
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-677-0188
Mailing Address - Street 1:880 E CAMPBELL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2341
Mailing Address - Country:US
Mailing Address - Phone:408-371-6003
Mailing Address - Fax:408-371-6009
Practice Address - Street 1:880 E CAMPBELL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2341
Practice Address - Country:US
Practice Address - Phone:408-371-6003
Practice Address - Fax:408-371-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty