Healthcare Provider Details

I. General information

NPI: 1154852218
Provider Name (Legal Business Name): WEYJUIN ERIC CHAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SANTA ANITA AVE
SOUTH EL MONTE CA
91733-3411
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL BOX 1149
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 626-579-7777
  • Fax:
Mailing address:
  • Phone: 212-824-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA172222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: