Provider Demographics
NPI:1942999727
Name:VAN BEEK, THOMAS WEI-HAO
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WEI-HAO
Last Name:VAN BEEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 TOLOSA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1220
Mailing Address - Country:US
Mailing Address - Phone:360-910-6242
Mailing Address - Fax:
Practice Address - Street 1:1212 MARSH ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3346
Practice Address - Country:US
Practice Address - Phone:805-703-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty