Healthcare Provider Details

I. General information

NPI: 1124075866
Provider Name (Legal Business Name): ANDREW P WENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BC CANCER AGENCY 600 WEST 10TH AVENUE
VANCOUVER BC
V5Z4E6
CA

IV. Provider business mailing address

BC CANCER AGENCY 600 WEST 10TH AVENUE
VANCOUVER BC
V5Z4E6
CA

V. Phone/Fax

Practice location:
  • Phone: 604-675-8136
  • Fax:
Mailing address:
  • Phone: 604-675-8136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number208174
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: