Healthcare Provider Details

I. General information

NPI: 1598853392
Provider Name (Legal Business Name): WEI-PING VIOLET SHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S MAIN ST
ORANGE CA
92868-3835
US

IV. Provider business mailing address

455 S MAIN ST
ORANGE CA
92868-3835
US

V. Phone/Fax

Practice location:
  • Phone: 714-516-4348
  • Fax: 714-532-8699
Mailing address:
  • Phone: 714-509-4348
  • Fax: 714-509-8699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberA39337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: