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General NPI Number Information
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NPI Number | 1588779557
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Entity Type | Individual
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Provider Name | VIVIAN M WENG O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 2191 MOWRY AVE STE 500F FREMONT
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City | FREMONT
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State | CA
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Zip | 94538-1725
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Country | US
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Telephone | 510-742-1004
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Fax | 510-742-1013
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Provider Business Mailing Address
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Address Line | 2191 MOWRY AVE STE 500F FREMONT
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City | FREMONT
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State | CA
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Zip | 94538-1725
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Country | US
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Telephone | 510-742-1004
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Fax | 510-742-1013
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 11492T
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License Number State | CA
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