Provider Demographics
NPI:1558961839
Name:LI, WENHUI LAURA (PHD)
Entity Type:Individual
Prefix:DR
First Name:WENHUI
Middle Name:LAURA
Last Name:LI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4623 BRIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3108
Mailing Address - Country:US
Mailing Address - Phone:310-429-3165
Mailing Address - Fax:
Practice Address - Street 1:25 MAUCHLY STE 313
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2361
Practice Address - Country:US
Practice Address - Phone:310-429-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADRN-02002537170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics