Provider Demographics
NPI:1427248319
Name:WANG, YI (MD)
Entity type:Individual
Prefix:DR
First Name:YI
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1661 HANOVER RD
Mailing Address - Street 2:#201
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1733
Mailing Address - Country:US
Mailing Address - Phone:626-965-4628
Mailing Address - Fax:626-965-4625
Practice Address - Street 1:1661 HANOVER RD
Practice Address - Street 2:#201
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1733
Practice Address - Country:US
Practice Address - Phone:626-965-4628
Practice Address - Fax:626-965-4625
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2008-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA98547207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine