Provider Demographics
NPI:1811262959
Name:WANG, ERIC D (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:D
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 S MANCHESTER AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3224
Mailing Address - Country:US
Mailing Address - Phone:714-456-5253
Mailing Address - Fax:714-456-7718
Practice Address - Street 1:200 S MANCHESTER AVE STE 650
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3224
Practice Address - Country:US
Practice Address - Phone:714-456-5253
Practice Address - Fax:714-456-7718
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1277872086S0105X, 2086S0122X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery