Provider Demographics
NPI:1790793289
Name:WANG, MAY LI (MD)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:LI
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11245 LOWER AZUSA RD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-1411
Mailing Address - Country:US
Mailing Address - Phone:626-579-9541
Mailing Address - Fax:626-579-9604
Practice Address - Street 1:11245 LOWER AZUSA RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731
Practice Address - Country:US
Practice Address - Phone:626-579-9541
Practice Address - Fax:626-579-9604
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2018-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA64130208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A641300Medicaid
CA00A641300Medicaid