Individual
DERRICK WEISON SU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11180 WARNER AVE STE 351, FOUNTAIN VALLEY, CA 92708-7516
(714) 698-0300
(714) 698-0313
Mailing address
11180 WARNER AVE, STE 351, FOUNTAIN VALLEY, CA 92708-7516
(714) 698-0300
(714) 698-0313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A125217
CA
Other
Enumeration date
08/09/2011
Last updated
05/15/2019
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