Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A107590 | CA |
NPI | 1043487101 |
---|---|
Provider Name | Dr. Andy Yen-Ming Wen |
First Address | Palo Alto, CA 94304-1511 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 14/10/2019 |