Provider Demographics
NPI:1093762825
Name:WEI, TIMOTHY Y (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:Y
Last Name:WEI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 N BROADWAY
Mailing Address - Street 2:SUITE 248
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3852
Mailing Address - Country:US
Mailing Address - Phone:925-938-5252
Mailing Address - Fax:925-938-1343
Practice Address - Street 1:1981 N BROADWAY
Practice Address - Street 2:SUITE 248
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3852
Practice Address - Country:US
Practice Address - Phone:925-938-5252
Practice Address - Fax:925-938-1343
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010759352084N0400X
CAC538122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H17891Medicare UPIN