Provider Demographics
NPI:1760749113
Name:WANG, MICHAEL CHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHEN
Last Name:WANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18805 COX AVE
Mailing Address - Street 2:SUITE #170
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-6616
Mailing Address - Country:US
Mailing Address - Phone:408-364-6600
Mailing Address - Fax:408-364-2041
Practice Address - Street 1:18805 COX AVE
Practice Address - Street 2:SUITE #170
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-6616
Practice Address - Country:US
Practice Address - Phone:408-364-6600
Practice Address - Fax:408-364-2041
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor