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General NPI Number Information
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NPI Number | 1720009301
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Entity Type | Individual
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Provider Name | NEIL STEVEN WENGER MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 200 MEDICAL PLAZA #365,530,420,120
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-206-0644
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Fax | 310-794-0732
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Provider Business Mailing Address
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Address Line | 200 UCLA MEDICAL PLZ STE 420
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City | LOS ANGELES
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State | CA
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Zip | 90095-8344
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Country | US
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Telephone | 310-206-6232
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Fax | 310-206-3551
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G55997
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License Number State | CA
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