Provider Demographics
NPI:1477517084
Name:WEN, CHIH-HSIN C (MD)
Entity Type:Individual
Prefix:
First Name:CHIH-HSIN
Middle Name:C
Last Name:WEN
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 1:3300 WEBSTER ST STE 710
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3122
Mailing Address - Country:US
Mailing Address - Phone:510-465-5800
Mailing Address - Fax:510-267-1833
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:710
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-465-5800
Practice Address - Fax:510-267-1833
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47781208800000X
CAA95156208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA95156OtherMEDICAL LICENSE