Provider Demographics
NPI:1912932187
Name:WANG, TZU CHIANG (MD)
Entity Type:Individual
Prefix:
First Name:TZU
Middle Name:CHIANG
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TZU
Other - Middle Name:C
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:353 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-5032
Mailing Address - Country:US
Mailing Address - Phone:713-988-2711
Mailing Address - Fax:713-988-3418
Practice Address - Street 1:353 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-5032
Practice Address - Country:US
Practice Address - Phone:713-988-2711
Practice Address - Fax:713-988-3418
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5793207R00000X
CA182356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1389348-13Medicaid
TXC23159Medicare UPIN
TX1389348-13Medicaid