Provider Demographics
NPI:1538488671
Name:WANG, PING ZE (MAT)
Entity type:Individual
Prefix:
First Name:PING
Middle Name:ZE
Last Name:WANG
Suffix:
Gender:M
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ULULANI STREET
Mailing Address - Street 2:#5
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-430-1095
Mailing Address - Fax:808-965-7061
Practice Address - Street 1:10 ULULANI STREET
Practice Address - Street 2:#5
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-430-1095
Practice Address - Fax:808-965-7061
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-10645171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist