Most Relevant Information
Provider Data
| NPI Number: | 1003183617 |
| Provider Name: | JACKSON WANG MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207RN0300X |
| Specialty: | Internal Medicine |
| License Number: | A119259 |
Most Important Dates
| Enumeration Date: | 11/28/2011 |
| Last Updated: | 05/19/2015 |
Provider Practice Location
10058 WOLF RD
GRASS VALLEY
CA
959498194
Practice Location Phone/Fax
| Phone: | 5302687708 |
| Fax: |
Provider Mailing Location
10058 WOLF RD
GRASS VALLEY
CA
959498194
Provider Mailing Phone/Fax
| Phone: | 5302687708 |
| Fax: |
Suggested EMR
Nephrology EMR