Healthcare Provider Details

I. General information

NPI: 1689640864
Provider Name (Legal Business Name): MARIA L. WEI M.D., PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST VA 190
SAN FRANCISCO CA
94121-0000
US

IV. Provider business mailing address

4150 CLEMENT ST VA 190
SAN FRANCISCO CA
94121-0000
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-751-3927
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-751-3927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA53307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: