Provider Demographics
NPI:1124322052
Name:SONNY S. WANG, M.D. COLON AND RECTAL SURGERY, INC.
Entity type:Organization
Organization Name:SONNY S. WANG, M.D. COLON AND RECTAL SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:SHENG-HUNG
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-387-7240
Mailing Address - Street 1:18 ENDEAVOR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3164
Mailing Address - Country:US
Mailing Address - Phone:949-387-7240
Mailing Address - Fax:949-387-7219
Practice Address - Street 1:18 ENDEAVOR
Practice Address - Street 2:SUITE 306
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3164
Practice Address - Country:US
Practice Address - Phone:949-387-7240
Practice Address - Fax:949-387-7219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81551208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty