MEDICARE: WEN-FENG JAN, MD PC

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	208000000X	Pediatrics Physician	A33039	CA
2	2080P0205X	Pediatric Endocrinology Physician	A33039	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669471876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEN-FENG JAN, MD PC

Provider Business Mailing Address
First Line	:	1920 E KATELLA AVE
Second Line	:	SUITE P
City	:	ORANGE
State	:	CA
Zip	:	92867-5146
Country	:	US
Telephone Number	:	714-639-3060
Fax Number	:	714-639-6471

Provider Business Practice Location Address
First Line	:	1920 E KATELLA AVE
Second Line	:	SUITE P
City	:	ORANGE
State	:	CA
Zip	:	92867-5146
Country	:	US
Telephone Number	:	714-639-3060
Fax Number	:	714-639-6471

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WEN FENG JAN
Credential	:	MD
Telephone Number	:	714-639-3060

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	10/24/2013

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