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General NPI Number Information
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NPI Number | 1336251628
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Entity Type | Organization
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Legal Business Name | SAN SAN WAI, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2211 W MAGNOLIA BLVD SUITE 230
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City | BURBANK
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State | CA
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Zip | 91506-1753
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Country | US
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Telephone | 818-391-1028
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Fax | 818-391-1037
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Provider Business Mailing Address
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Address Line | 2211W MAGNOLIA BLVD SUITE 230
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City | BURBANK
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State | CA
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Zip | 91506-1762
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Country | US
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Telephone | 818-391-1028
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Fax | 818-391-1037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAN SAN WAI
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Credential | M.D.
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Telephone | 818-391-1028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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