Healthcare Provider Details

I. General information

NPI: 1770625378
Provider Name (Legal Business Name): BARBARA ELLEN WEISS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 REEVES ST APT 207
LOS ANGELES CA
90035-2951
US

IV. Provider business mailing address

1440 REEVES ST APT 207
LOS ANGELES CA
90035-2951
US

V. Phone/Fax

Practice location:
  • Phone: 310-556-2272
  • Fax:
Mailing address:
  • Phone: 310-556-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberG68112
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG68112
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: