Provider Demographics
NPI:1740242189
Name:WANG, TING (MD)
Entity type:Individual
Prefix:
First Name:TING
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11875 DUBLIN BLVD
Mailing Address - Street 2:SUITE C140
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2843
Mailing Address - Country:US
Mailing Address - Phone:925-587-2505
Mailing Address - Fax:925-587-2511
Practice Address - Street 1:5720 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 240
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2828
Practice Address - Country:US
Practice Address - Phone:925-463-1234
Practice Address - Fax:925-463-9599
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA39974208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics