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General NPI Number Information
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NPI Number | 1689742082
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Entity Type | Individual
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Provider Name | SHUMIN WEN DDS
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 355 W MANCHESTER AVE
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City | LOS ANGELES
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State | CA
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Zip | 90003-3327
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Country | US
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Telephone | 323-751-4100
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Fax | 323-751-2853
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Provider Business Mailing Address
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Address Line | 1038 PARK AVE
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City | ARCADIA
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State | CA
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Zip | 91007-6949
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Country | US
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Telephone | 626-445-7882
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Fax | 626-445-7882
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 48058
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License Number State | CA
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