Basic Information
Provider Information
NPI: 1790045714
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEI
FirstName: RANDY
MiddleName: LI-HUNG
NamePrefix:  
NameSuffix:  
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18111 BROOKHURST ST. LL0300
Address2:  
City: FOUNTAIN VALLEY
State: CA
PostalCode: 927086728
CountryCode: US
TelephoneNumber: 4087588833
FaxNumber:  
Practice Location
Address1: 5901 E 7TH ST
Address2:  
City: LONG BEACH
State: CA
PostalCode: 908225201
CountryCode: US
TelephoneNumber: 7149627100
FaxNumber: 7149637600
Other Information
ProviderEnumerationDate: 05/23/2012
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XA129580CAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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