Provider Demographics
NPI:1982800249
Name:JAMES NIEN CHIN WANG, D.O., INC.
Entity Type:Organization
Organization Name:JAMES NIEN CHIN WANG, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-284-7788
Mailing Address - Street 1:103 N GARFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3555
Mailing Address - Country:US
Mailing Address - Phone:626-284-7788
Mailing Address - Fax:626-284-6255
Practice Address - Street 1:103 N GARFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3555
Practice Address - Country:US
Practice Address - Phone:626-284-7788
Practice Address - Fax:626-284-6255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8055207Q00000X
CAG66648207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1134163637OtherDR. WANG'S NPI
CA1821030305OtherDR. CHIENG'S NPI
CA1821030305OtherDR. CHIENG'S NPI
CAF14971Medicare UPIN