Provider Demographics
NPI:1689741654
Name:WEI, JOHN CHII-SEN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHII-SEN
Last Name:WEI
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 1:3224 SANTA ANA ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-2306
Mailing Address - Country:US
Mailing Address - Phone:323-567-2384
Mailing Address - Fax:323-569-9840
Practice Address - Street 1:3224 SANTA ANA ST
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-2306
Practice Address - Country:US
Practice Address - Phone:323-567-2384
Practice Address - Fax:323-569-9840
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34899207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A348990Medicaid
CAWA34899BMedicare ID - Type UnspecifiedPPIN
CAW7934AMedicare PIN
CAW7934Medicare PIN
CAA27623Medicare UPIN
CA00A348990Medicaid