MEDICARE: JAFFRAY WEE

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	343900000X	Non-emergency Medical Transport (VAN)	A9025336	CA

General Provider Information

NPI Number	:	1588078455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAFFRAY WEE

Provider Business Mailing Address
First Line	:	3717 COUNTRY CLUB DR UNIT 8
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3137
Country	:	US
Telephone Number	:	562-879-0807
Fax Number	:

Provider Business Practice Location Address
First Line	:	3717 COUNTRY CLUB DR UNIT 8
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3137
Country	:	US
Telephone Number	:	562-879-0807
Fax Number	:

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

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	06/18/2014

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Directions to “ JAFFRAY WEE ” Practice Location

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