Provider Demographics
NPI:1639207483
Name:WANG, JIN YANG (DOCTOR)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:YANG
Last Name:WANG
Suffix:
Gender:F
Credentials:DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451W.EL CAMINO REAL JIN YANG WANG
Mailing Address - Street 2:C
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040
Mailing Address - Country:US
Mailing Address - Phone:650-938-1988
Mailing Address - Fax:
Practice Address - Street 1:451W.EL CAMINO REAL JIN YANG WANG
Practice Address - Street 2:C
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040
Practice Address - Country:US
Practice Address - Phone:650-938-1988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11107171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA207OtherUSA49