Provider Demographics
NPI:1205901642
Name:WANG, ZHENG (MD)
Entity type:Individual
Prefix:DR
First Name:ZHENG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18044 CLARKE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-8742
Mailing Address - Country:US
Mailing Address - Phone:951-776-4256
Mailing Address - Fax:951-776-4256
Practice Address - Street 1:18044 CLARKE CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-8742
Practice Address - Country:US
Practice Address - Phone:951-776-4256
Practice Address - Fax:951-776-4256
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65385207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A653850Medicaid
CA00A653850Medicaid