Provider Demographics
NPI:1528178332
Name:MA, GEORGE WEE KENG (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WEE KENG
Last Name:MA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:711 W COLLEGE ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1163
Mailing Address - Country:US
Mailing Address - Phone:213-621-2998
Mailing Address - Fax:213-621-2158
Practice Address - Street 1:711 W COLLEGE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1163
Practice Address - Country:US
Practice Address - Phone:213-621-2998
Practice Address - Fax:213-621-2158
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG23017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB51005Medicare UPIN