Healthcare Provider Details

I. General information

NPI: 1124342720
Provider Name (Legal Business Name): DR. CHYI WEI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 W CHARLESTON BLVD
LAS VEGAS NV
89102-2227
US

IV. Provider business mailing address

2510W DUNLAP AVE 290
PHOENIX AZ
85021-2759
US

V. Phone/Fax

Practice location:
  • Phone: 702-671-2236
  • Fax:
Mailing address:
  • Phone: 602-789-0344
  • Fax: 602-870-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number48371
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number17640
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: