Provider Demographics
NPI:1639523616
Name:WANG, STEVEN ZHIXIE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ZHIXIE
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2101 FOREST AVE STE 220A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1473
Mailing Address - Country:US
Mailing Address - Phone:408-295-8628
Mailing Address - Fax:408-295-8061
Practice Address - Street 1:2101 FOREST AVE STE 220A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1473
Practice Address - Country:US
Practice Address - Phone:408-295-8628
Practice Address - Fax:408-295-8061
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA173527208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine