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General NPI Number Information
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NPI Number | 1114411352
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Entity Type | Individual
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Provider Name | JIN WEN SUI MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 999 N TUSTIN AVE STE 109
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City | SANTA ANA
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State | CA
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Zip | 92705-6501
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Country | US
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Telephone | 714-954-1182
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Fax | 714-953-3425
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Provider Business Mailing Address
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Address Line | PO BOX 3428
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City | TUSTIN
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State | CA
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Zip | 92781-3428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | A165749
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License Number State | CA
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