Provider Demographics
NPI:1730317603
Name:WANG, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:26730 CROWN VALLEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8001
Mailing Address - Country:US
Mailing Address - Phone:949-364-2154
Mailing Address - Fax:949-364-2110
Practice Address - Street 1:26730 CROWN VALLEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8001
Practice Address - Country:US
Practice Address - Phone:949-364-2154
Practice Address - Fax:949-364-2110
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA130943207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CB242792Medicare UPIN