Individual
WEI DER SHOW
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3301 N EASTERN AVE, LOS ANGELES, CA 90032-1931
(323) 225-2351
(323) 225-7555
Mailing address
3301 N EASTERN AVE, LOS ANGELES, CA 90032-1931
(323) 225-2351
(323) 225-7555
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A48048
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A480480
—
CA
Enumeration date
06/11/2006
Last updated
07/09/2007
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