Provider Demographics
NPI:1902012362
Name:WANG, LILLIAN ING-LING (OD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:ING-LING
Last Name:WANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-3002
Mailing Address - Country:US
Mailing Address - Phone:925-377-1097
Mailing Address - Fax:
Practice Address - Street 1:503 AUGUSTA DR
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-3002
Practice Address - Country:US
Practice Address - Phone:925-377-1097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1146TLG152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics