Healthcare Provider Details

I. General information

NPI: 1831293018
Provider Name (Legal Business Name): JESSICA TSAO-CHIN WEI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 04/05/2024
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 SANTA MONICA BLVD FL 2
WEST HOLLYWOOD CA
90069-4496
US

IV. Provider business mailing address

100 CAMBRIDGE ST FL 14
BOSTON MA
02114-2509
US

V. Phone/Fax

Practice location:
  • Phone: 909-962-1260
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number041252
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number041252
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: