Basic Information
| Provider Information | |||||||||
| NPI: | 1205126505 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEN | ||||||||
| FirstName: | AKI | ||||||||
| MiddleName: | YEN CHANG | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10170 SORRENTO VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921211604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8587845888 | ||||||||
| FaxNumber: | 8587845960 | ||||||||
| Practice Location | |||||||||
| Address1: | 6386 ALVARADO CT STE 310 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921204908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6197137899 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2011 | ||||||||
| LastUpdateDate: | 03/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A12555 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.