Provider Demographics
NPI:1023043304
Name:WEE, CHOONG YANG (MD)
Entity Type:Individual
Prefix:DR
First Name:CHOONG
Middle Name:YANG
Last Name:WEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 PACIFIC AVE
Mailing Address - Street 2:340
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2657
Mailing Address - Country:US
Mailing Address - Phone:562-424-3100
Mailing Address - Fax:562-595-0953
Practice Address - Street 1:2690 PACIFIC AVE
Practice Address - Street 2:340
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2657
Practice Address - Country:US
Practice Address - Phone:562-424-3100
Practice Address - Fax:562-595-0953
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC39800174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8759617Medicaid
CAA88135Medicare UPIN
CA8759617Medicaid