Healthcare Provider Details

I. General information

NPI: 1982889416
Provider Name (Legal Business Name): STEVEN F WEINSTEIN MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 07/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 AVOCADO SUITE 602
NEWPORT BEACH CA
92660
US

IV. Provider business mailing address

17742 BEACH BLVD SUITE 310
HUNTINGTON BEACH CA
92647
US

V. Phone/Fax

Practice location:
  • Phone: 714-848-8585
  • Fax: 714-848-0766
Mailing address:
  • Phone: 714-848-8585
  • Fax: 714-848-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberG23590
License Number StateCA

VIII. Authorized Official

Name: STEVEN F WEINSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 714-848-8585