Provider Demographics
NPI:1922502962
Name:LOALLEN, WEEI (MD)
Entity Type:Individual
Prefix:
First Name:WEEI
Middle Name:
Last Name:LOALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WEEI
Other - Middle Name:
Other - Last Name:LO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2010 ZONAL AVE.
Mailing Address - Street 2:1ST FLOOR, 1P51
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033
Mailing Address - Country:US
Mailing Address - Phone:818-920-8094
Mailing Address - Fax:430-249-0567
Practice Address - Street 1:2010 ZONAL AVE
Practice Address - Street 2:1ST FLOOR, 1P51
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-9003
Practice Address - Country:US
Practice Address - Phone:818-920-8094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1648922084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program