Provider Demographics
NPI:1740339100
Name:WANG, ZUI-SHIANG (MD)
Entity type:Individual
Prefix:
First Name:ZUI-SHIANG
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 MOUNTAIN VIEW AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3834
Mailing Address - Country:US
Mailing Address - Phone:909-796-8393
Mailing Address - Fax:909-796-0783
Practice Address - Street 1:11360 MOUNTAIN VIEW AVE STE B
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3834
Practice Address - Country:US
Practice Address - Phone:909-796-8393
Practice Address - Fax:909-796-0783
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA4321420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A321420Medicaid