Provider Demographics
NPI:1427048693
Name:WANG, YUJEN (MD)
Entity type:Individual
Prefix:DR
First Name:YUJEN
Middle Name:
Last Name:WANG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8281
Mailing Address - Country:US
Mailing Address - Phone:541-770-2020
Mailing Address - Fax:541-200-2599
Practice Address - Street 1:1518 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8281
Practice Address - Country:US
Practice Address - Phone:541-770-2020
Practice Address - Fax:541-200-2599
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64569207WX0107X
ORMD23935207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR286802Medicaid
OR112735Medicare PIN
OR180044613Medicare PIN
H22959Medicare UPIN