Provider Demographics
NPI:1851498372
Name:CHEN, WILLIAM WEI MING (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WEI MING
Last Name:CHEN
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 1:2089 VALE RD
Mailing Address - Street 2:#34
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806
Mailing Address - Country:US
Mailing Address - Phone:510-235-9247
Mailing Address - Fax:510-235-9248
Practice Address - Street 1:2089 VALE RD
Practice Address - Street 2:#34
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806
Practice Address - Country:US
Practice Address - Phone:510-235-9247
Practice Address - Fax:510-235-9248
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA070200207K00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A702000OtherBS OF CA
431996194OtherBC OF CA
CAA702000Medicaid
CAZZZ25764ZMedicare ID - Type Unspecified
CAA702000Medicaid