Provider Demographics
NPI:1649620857
Name:WANG, CHARLES YEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:YEE
Last Name:WANG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E YALE LOOP STE 201
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4697
Mailing Address - Country:US
Mailing Address - Phone:949-265-2442
Mailing Address - Fax:949-265-2448
Practice Address - Street 1:250 E YALE LOOP STE 201
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4697
Practice Address - Country:US
Practice Address - Phone:949-265-2442
Practice Address - Fax:949-265-2448
Is Sole Proprietor?:No
Enumeration Date:2016-06-18
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12256225100000X
CA293713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist