Provider Demographics
NPI:1194051219
Name:WEI, JENNIFER JIA-PERNG (MD, PHD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JIA-PERNG
Last Name:WEI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:JIA-PERNG
Other - Middle Name:JENNIFER
Other - Last Name:WEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:22 MORGAN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2022
Mailing Address - Country:US
Mailing Address - Phone:949-540-6300
Mailing Address - Fax:888-422-2530
Practice Address - Street 1:22 MORGAN
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2022
Practice Address - Country:US
Practice Address - Phone:949-540-6300
Practice Address - Fax:888-422-2530
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95155207ZP0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology