Provider Demographics
NPI:1306942644
Name:WANG, YUBAO (MD)
Entity type:Individual
Prefix:DR
First Name:YUBAO
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 1:1450 TREAT BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2168
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:
Practice Address - Street 1:2675 PLEASANT HILL RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2033
Practice Address - Country:US
Practice Address - Phone:925-677-5041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC149361207RH0003X
MO2006004166207R00000X
NY268689207RH0003X
NMMD2017-0211207RH0003X
TXM5569207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1306942644OtherUNIVERA
NY03641018Medicaid
TX195626001Medicaid
NY000535508001OtherBSWNY
NM5908574Medicaid
NY2717438OtherINDEPENDENT HEALTH
NY2717438OtherINDEPENDENT HEALTH