Provider Demographics
NPI:1063437499
Name:WANG, CHING (MD)
Entity type:Individual
Prefix:DR
First Name:CHING
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6123
Mailing Address - Country:US
Mailing Address - Phone:928-344-4216
Mailing Address - Fax:928-726-3799
Practice Address - Street 1:2060 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6123
Practice Address - Country:US
Practice Address - Phone:928-344-4216
Practice Address - Fax:928-726-3799
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24011207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962507376OtherCLINIC NPI
1043324932OtherCLINIC NPI
1063433720OtherCLINIC NPI
1245344316OtherCLINIC NPI
AZ344672Medicaid
1962507376OtherCLINIC NPI
AZZ107259Medicare PIN
1063433720OtherCLINIC NPI
AZZ21115Medicare PIN
1245344316OtherCLINIC NPI
AZ344672Medicaid
AZZ107248Medicare PIN
1043324932OtherCLINIC NPI
031822Medicare Oscar/Certification
AZZ21130Medicare PIN
G31290Medicare UPIN
031824Medicare Oscar/Certification
AZZ21113Medicare PIN
AZZ21115Medicare PIN