Healthcare Provider Details

I. General information

NPI: 1669801262
Provider Name (Legal Business Name): NAFTOLI H WEINGARTEN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E SAN ANTONIO DR
LONG BEACH CA
90807-2211
US

IV. Provider business mailing address

901 E SAN ANTONIO DR
LONG BEACH CA
90807-2211
US

V. Phone/Fax

Practice location:
  • Phone: 562-422-3338
  • Fax: 562-422-3339
Mailing address:
  • Phone: 562-422-3338
  • Fax: 562-422-3339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5045
License Number StateCA

VIII. Authorized Official

Name: DR. NAFTOLI H WEINGARTEN
Title or Position: PRESIDENT
Credential: DPM
Phone: 562-422-3338