MEDICARE: DR. GEORGE WEE KENG MA M.D.

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	207R00000X	Internal Medicine Physician	G23017	CA

General Provider Information

NPI Number	:	1528178332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE WEE KENG MA M.D.

Provider Business Mailing Address
First Line	:	711 W COLLEGE ST
Second Line	:	SUITE 210
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1163
Country	:	US
Telephone Number	:	213-621-2998
Fax Number	:	213-621-2158

Provider Business Practice Location Address
First Line	:	711 W COLLEGE ST
Second Line	:	SUITE 210
City	:	LOS ANGELES
State	:	CA
Zip	:	90012-1163
Country	:	US
Telephone Number	:	213-621-2998
Fax Number	:	213-621-2158

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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