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General NPI Number Information
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NPI Number | 1861430902
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Entity Type | Individual
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Provider Name | WEI WAH KWOK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 150 LAGUNA RD STE A
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City | FULLERTON
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State | CA
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Zip | 92835-3614
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Country | US
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Telephone | 714-525-8822
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Fax | 714-525-5193
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Provider Business Mailing Address
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Address Line | 150 LAGUNA RD STE A
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City | FULLERTON
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State | CA
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Zip | 92835-3614
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Country | US
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Telephone | 714-525-8822
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Fax | 714-525-5193
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A90368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A90368
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License Number State | CA
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