Basic Information
| Provider Information | |||||||||
| NPI: | 1760825517 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WEI | ||||||||
| FirstName: | ALAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11175 CAMPUS ST | ||||||||
| Address2: | COLEMAN PAVILION, SUITE 11120 | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095588291 | ||||||||
| FaxNumber: | 9095580440 | ||||||||
| Practice Location | |||||||||
| Address1: | 11234 ANDERSON ST | ||||||||
| Address2: | GME OFFICE WESTERLY SUITE C | ||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923542804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095584174 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A135747 | CA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | A135747 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.