Provider Demographics
NPI:1760748859
Name:WANG, CHONGHUA (MD)
Entity type:Individual
Prefix:DR
First Name:CHONGHUA
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARL
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3762 TIBBETTS ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2605
Mailing Address - Country:US
Mailing Address - Phone:949-414-7246
Mailing Address - Fax:949-757-3846
Practice Address - Street 1:3762 TIBBETTS ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2605
Practice Address - Country:US
Practice Address - Phone:949-414-7246
Practice Address - Fax:949-757-3846
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2025-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128621208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine