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NPI Code Detail

MEDICARE: SAM JAY WEISS M.D.

MEDICARE: SAM JAY WEISS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207KA0200XAllergy PhysicianG54907CA

General Provider Information

NPI Number : 1881692655
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAM JAY WEISS M.D.
Provider Business Mailing Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3221
Country : US
Telephone Number : 760-346-2070
Fax Number : 760-346-4495
Provider Business Practice Location Address
First Line : 39000 BOB HOPE DR
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-3221
Country : US
Telephone Number : 760-346-2070
Fax Number : 760-346-4495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 07/28/2020

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