| Dr. Nancy Wang, Od, Inc. | |
|
300 N Euclid Ave Ste A Upland CA 91786-6031 | |
| (909) 982-9002 | |
| (909) 982-9912 |
| Full Name | Dr. Nancy Wang, Od, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 N Euclid Ave Ste A, Upland, California |
| Authorized Official Name and Position | Nancy Wang (OWNER) |
| Authorized Official Contact | 9099829002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Nancy Wang, Od, Inc. 300 N Euclid Ave Ste A Upland CA 91786-6031 Ph: (909) 982-9002 | Dr. Nancy Wang, Od, Inc. 300 N Euclid Ave Ste A Upland CA 91786-6031 Ph: (909) 982-9002 |
| NPI Number | 1760671267 |
|---|---|
| Provider Enumeration Date | 10/19/2007 |
| Last Update Date | 02/29/2008 |
| Medicare PECOS PAC ID | 8123115102 |
|---|---|
| Medicare Enrollment ID | O20071107000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760671267 | NPI | - | NPPES |
| SD0112330 | Medicaid | CA | |
| OP112333 | Other | CA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 11233T (California) | Primary |
| 332H00000X | Eyewear Supplier | 11233T (California) | Secondary |
| Provider Name | Nancy Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750466264 PECOS PAC ID: 6305933383 Enrollment ID: I20071107000852 |
| Provider Name | Nataly Kalbakji |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700556438 PECOS PAC ID: 4385032622 Enrollment ID: I20211019002454 |
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