| Dejun Wang M.d. Inc | |
|
19115 Colima Rd Unit 104 Rowland Heights CA 91748-3074 | |
| (626) 810-2983 | |
| (626) 810-5741 |
| Full Name | Dejun Wang M.d. Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 19115 Colima Rd Unit 104, Rowland Heights, California |
| Authorized Official Name and Position | Dejun Wang (PRESIDENT) |
| Authorized Official Contact | 6268102983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dejun Wang M.d. Inc 18391 Colima Rd 204 Rowland Heights CA 91748-2730 Ph: (626) 810-2983 | Dejun Wang M.d. Inc 19115 Colima Rd Unit 104 Rowland Heights CA 91748-3074 Ph: (626) 810-2983 |
| NPI Number | 1811211659 |
|---|---|
| Provider Enumeration Date | 03/23/2010 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 6103952569 |
|---|---|
| Medicare Enrollment ID | O20100325000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811211659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A71575 (California) | Primary |
| Provider Name | Dejun Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275559288 PECOS PAC ID: 4789676651 Enrollment ID: I20040331001224 |
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Jack Wu Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 19115 Colima Rd Unit 202, Rowland Heights, CA 91748 Phone: 626-912-4147 Fax: 626-912-3326 | |
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