Wieke H Liem, M.D.,Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G70387 Issued in CA

Legal business name

WIEKE H LIEM, M.D.,INC.

Practice address

17601 17TH St Ste 110
Tustin, CA 92780-1949

Phone

(714) 790-0005

Fax

(714) 538-1082

NPI assigned

May 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wieke H Liem, M.D.NPI 1164452546

Title

President

Phone

(714) 790-0005

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wieke H Liem, M.D.

  • Dermatology Physician
  • Tustin, CA
  • NPI 1164452546
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1073729257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-699-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-538-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIEKE H LIEM, M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "LIEM",
        "authorized_official_first_name": "WIEKE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-790-0005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G70387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G70387",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G703871",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Catherine Magpantay White
• Sean Whiteley, APCC
• Josephine P. Whitney, MFT
• Melissa Whitworth
• Whole Fitness Inc
• Elizabeth Irene Williams
• Fernanda Williams
• Heather Williams
• Marlene Williams
• Sanaii M Williams

• Dermatology Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.