Doctor Name: | KENNETH C WEN |
NPI Number: | 1003980822 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 231432 |
Business Practice Address: | 3080 Bristol St Suite 600 Costa Mesa, CA - 926263093 |
Business Phone Number: | 7144450220 |
Business Fax Number: | 7144450246 |
Mailing Address: | 3080 Bristol St, Suite 600 COSTA MESA |
State: | CA |
Postal Code: | 926263093 |
Phone Number: | 7144450220 |
Fax Number: | 7144450246 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 10/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RC0000X |
License Number: | 231432 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Cardiovascular Disease |
Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |