Bryant Wang
Specialist/Technologist, Athletic Trainer in San Dimas, CA. Individual provider (NPI-1).
NPI number1497258446
StatusActive
Last updated in NPPESNov 18, 2019
Details
- NPI
- 1497258446
- Entity type
- Individual (NPI-1)
- Name
- Bryant Wang
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 16, 2018
- Last updated
- Nov 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1100 W Covina BlvdSan Dimas, CA 91773
Phone 909-599-5433
Mailing address
1100 W Covina BlvdSan Dimas, CA 91773-3203
Phone 909-599-5433
Other practice locations
1100 W Covina Blvd
San Dimas, CA 91773
San Dimas, CA 91773
Phone 909-599-5433
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