Healthcare Provider Details

I. General information

NPI: 1952475550
Provider Name (Legal Business Name): DANA M. WEISSHAAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 PEACH WILLOW CT
LOS GATOS CA
95032-1362
US

IV. Provider business mailing address

160 CAMBRIDGEPARK DR UNIT 112
CAMBRIDGE MA
02140-2452
US

V. Phone/Fax

Practice location:
  • Phone: 617-286-6874
  • Fax: 508-206-8173
Mailing address:
  • Phone: 617-286-6874
  • Fax: 508-206-8173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberG75915
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG075915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: