| Douglas Wang, | |
| 11234 Anderson Street, Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 | |
| (909) 558-4174 | |
| Not Available | 
| Full Name | Douglas Wang | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine | 
| Location | 11234 Anderson Street, Loma Linda, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013572015 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | A179449 (California) | Primary | 
| 208000000X | Pediatrics | A179449 (California) | Secondary | 
| Entity Name | Faculty Physicians And Surgeons Of Llusm | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 | 
| Entity Name | Faculty Physicians And Surgeons Of Llusm | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1508255175 PECOS PAC ID: 1153227814 Enrollment ID: O20160216002196 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Douglas Wang, 11234 Anderson Street, Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 Ph: (909) 558-4174 | Douglas Wang, 11234 Anderson Street, Gme Office Westerly Suite C, Loma Linda, CA 92354-2804 Ph: (909) 558-4174 | 
| Petru Papacostea,  Internal Medicine Medicare: Medicare Enrolled Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084 | |
| Dr. Moosa Azadian, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 909-558-4085 | |
| Shahab Sean Shahangian, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 818-532-8211 | |
| Golda Marcell Harvatin, D.O. Internal Medicine Medicare: Medicare Enrolled Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 909-558-4000 | |
| Mst Nurjahan Khatun, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 11234 Anderson St # C, Loma Linda, CA 92354 Phone: 408-355-8650 | |
| Snorri Olafsson, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 11370 Anderson St, Ste 3150, Loma Linda, CA 92354 Phone: 909-558-2191 |