MEDICARE: ASHTEN BROOK WAKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	A160153	CA

General Provider Information

NPI Number	:	1356847826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHTEN BROOK WAKS

Provider Business Mailing Address
First Line	:	520 ULTIMO AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90814-2045
Country	:	US
Telephone Number	:	949-702-0704
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 THE CITY DR S
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92868-3201
Country	:	US
Telephone Number	:	714-456-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	03/18/2026

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Directions to “ ASHTEN BROOK WAKS ” Practice Location

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