Provider Demographics
NPI:1831492230
Name:WANG, YING
Entity Type:Individual
Prefix:
First Name:YING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 S BERNARDO AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1020
Mailing Address - Country:US
Mailing Address - Phone:408-732-5902
Mailing Address - Fax:408-732-5914
Practice Address - Street 1:639 S BERNARDO AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1020
Practice Address - Country:US
Practice Address - Phone:408-732-5902
Practice Address - Fax:408-732-5914
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist