Provider Demographics
NPI:1689479545
Name:WANG, SHARON HSUEH CHUN
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:HSUEH CHUN
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 E DOUBLEGROVE ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-4036
Mailing Address - Country:US
Mailing Address - Phone:909-348-2994
Mailing Address - Fax:
Practice Address - Street 1:600 N GARFIELD AVE STE 100
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1167
Practice Address - Country:US
Practice Address - Phone:626-927-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033954363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily