Provider Demographics
NPI:1700055217
Name:ALLAN WANG MD LLC
Entity Type:Organization
Organization Name:ALLAN WANG MD LLC
Other - Org Name:HAWAII ALLERGY ASTHMA & IMMUNOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:VEH TUC
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:808-989-6543
Mailing Address - Street 1:PO BOX 31000
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96849-5516
Mailing Address - Country:US
Mailing Address - Phone:808-329-9264
Mailing Address - Fax:
Practice Address - Street 1:75-166 KALANI ST
Practice Address - Street 2:SUITE 204
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1857
Practice Address - Country:US
Practice Address - Phone:808-329-9264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9287207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH57130Medicare PIN