Provider Demographics
NPI:1871782185
Name:HENRY HEUNG-HWAN WEE MD INC
Entity type:Organization
Organization Name:HENRY HEUNG-HWAN WEE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:HEUNG-HWAN
Authorized Official - Last Name:WEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-636-0342
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92842-0775
Mailing Address - Country:US
Mailing Address - Phone:714-636-0342
Mailing Address - Fax:714-636-0391
Practice Address - Street 1:2701 S BRISTOL ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6201
Practice Address - Country:US
Practice Address - Phone:714-636-0342
Practice Address - Fax:714-636-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31904207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABD377OtherMEDICARE PTAN
CA00A319040Medicaid
CAB50180Medicare UPIN
CAA31904Medicare PIN