Provider Demographics
NPI:1194905323
Name:DANIEL Y WANG MD CORP
Entity type:Organization
Organization Name:DANIEL Y WANG MD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:YU
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-636-1332
Mailing Address - Street 1:920 SUNNYSLOPE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5784
Mailing Address - Country:US
Mailing Address - Phone:831-636-1332
Mailing Address - Fax:831-636-1342
Practice Address - Street 1:920 SUNNYSLOPE RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5784
Practice Address - Country:US
Practice Address - Phone:831-636-1332
Practice Address - Fax:831-636-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96792261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center