Provider Demographics
NPI:1770266231
Name:LOW, WAN LING (PA-S)
Entity type:Individual
Prefix:
First Name:WAN LING
Middle Name:
Last Name:LOW
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:NERISSA
Other - Middle Name:
Other - Last Name:LOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-S
Mailing Address - Street 1:130 E CHAPMAN AVE APT 315
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-4917
Mailing Address - Country:US
Mailing Address - Phone:925-588-9942
Mailing Address - Fax:
Practice Address - Street 1:130 E CHAPMAN AVE APT 315
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-4917
Practice Address - Country:US
Practice Address - Phone:925-588-9942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program