Individual provider · Type 1 NPI

Theodore Thompson Wang

Student in an Organized Health Care Education/Training Program · Los Angeles, CA

NPI number 1578199501 Active

Practice location

4733 W Sunset Blvd Fl 3
Los Angeles, CA 90027-6021

Call (833) 574-2273 Map

Other practice locations

  • 401 Bicentennial Way, Santa Rosa, CA 95403-2149 · (707) 393-4000

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202XA181864 (CA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1578199501

Theodore Thompson Wang's National Provider Identifier is 1578199501, issued on Mar 21, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Los Angeles, CA. The record was last updated on Sep 9, 2025.