Provider Demographics
NPI:1740493048
Name:TIEN, WENDY CHERN WAN (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:CHERN WAN
Last Name:TIEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-843-2835
Mailing Address - Fax:818-843-3310
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-843-2835
Practice Address - Fax:818-843-3310
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA996882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA99688OtherCALIFORNIA LICENSE NUMBER
1740493048OtherNPI