Provider Demographics
NPI:1942277579
Name:WANG, JO H (ATC, CSCS, PES)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:H
Last Name:WANG
Suffix:
Gender:M
Credentials:ATC, CSCS, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S FIGUEROA ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-1300
Mailing Address - Country:US
Mailing Address - Phone:213-742-7563
Mailing Address - Fax:
Practice Address - Street 1:1111 S FIGUEROA ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1300
Practice Address - Country:US
Practice Address - Phone:213-742-7563
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer