Healthcare Provider Details

I. General information

NPI: 1417022856
Provider Name (Legal Business Name): WILLIAM WEISS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NEUROLOGY UNIV OF CA 533 PARNASSUS AVE, ROOM U441K
SAN FRANCISCO CA
94143-0001
US

IV. Provider business mailing address

1450 THIRD ST NEUROLOGY UNIV OF CA, ROOM HD277
SAN FRANCISCO CA
94158-9001
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberG72677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: