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General NPI Number Information
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NPI Number | 1386686889
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Entity Type | Individual
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Provider Name | WEI DER SHOW M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3301 N EASTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90032-1931
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Country | US
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Telephone | 323-225-2351
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Fax | 323-225-7555
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Provider Business Mailing Address
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Address Line | 3301 N EASTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90032-1931
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Country | US
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Telephone | 323-225-2351
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Fax | 323-225-7555
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A48048
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License Number State | CA
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