Organization Active NPI

Weiguo Li, LLC

Doing business as Pennsylvania Union Medical Center

  • Family Medicine Physician
  • King of Prussia, PA
National Provider Identifier
1083801773
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD432040 Issued in PA
Legal business name
WEIGUO LI, LLC
Doing business as
Pennsylvania Union Medical Center
Practice address
625 Clark Avenue
Suite 17a
King of Prussia, PA 19406-3065
Phone
(610) 768-7168
Fax
(610) 768-7169
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Dr. Weiguo Victor Li, MDNPI 1295931038
Title
President
Phone
(610) 768-7168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD432040 PA Primary

Addresses

Primary practice location

625 Clark Avenue
Suite 17a
King of Prussia, PA 19406-3065

Mailing address

625 Clark Avenue
Suite 17a
King of Prussia, PA 19406-3065
Phone (610) 768-7168

Other names 1

  • Pennsylvania Union Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080219000333 PA Part B Supplier - Clinic/Group Practice 0749363414 Receives reassigned benefits from 2 practitioners
Practice locations: King of Prussia, PA

National Provider Directory

National Provider Directory

Locations

677 W DeKalb Pike
Ste 15
King of Prussia, PA 19406
Phone (610) 768-7168

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1083801773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLARK AVENUE",
            "address_2": "SUITE 17A",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063065",
            "telephone_number": "610-768-7168",
            "fax_number": "610-768-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLARK AVENUE",
            "address_2": "SUITE 17A",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063065",
            "telephone_number": "610-768-7168",
            "fax_number": "610-768-7169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEIGUO LI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "WEIGUO",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-768-7168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD432040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pennsylvania Union Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.