Healthcare Provider Details

I. General information

NPI: 1801901574
Provider Name (Legal Business Name): DARYL A WEIN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 W F ST
OAKDALE CA
95361-3844
US

IV. Provider business mailing address

PO BOX 2156
OAKDALE CA
95361-5156
US

V. Phone/Fax

Practice location:
  • Phone: 209-848-2273
  • Fax: 209-848-0242
Mailing address:
  • Phone: 209-848-2273
  • Fax: 209-848-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: