Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A130197 | CA |
N | 208600000X | Surgeon | A130197 | CA |
Y | 2086S0120X | Pediatric Surgery | A130197 | CA |
NPI | 1558650200 |
---|---|
Provider Name | Mrs. Minna Minsing Chen Wieck |
First Address | Sacramento, CA 95817 |
Second Address | Sacramento, CA 95817-2215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 27/08/2020 |