Provider Demographics
NPI:1841451606
Name:CHEN, WEI KUO (DDS)
Entity type:Individual
Prefix:
First Name:WEI KUO
Middle Name:
Last Name:CHEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:WEIKUO
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5211 PACIFIC CONCOURSE DR
Mailing Address - Street 2:APT 1358
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-6917
Mailing Address - Country:US
Mailing Address - Phone:424-901-9699
Mailing Address - Fax:
Practice Address - Street 1:5211 PACIFIC CONCOURSE DR
Practice Address - Street 2:APT 1358
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6917
Practice Address - Country:US
Practice Address - Phone:424-901-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA566601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice