Healthcare Provider Details

I. General information

NPI: 1750887220
Provider Name (Legal Business Name): ANDREA WEISS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 BATH ST STE 113
SANTA BARBARA CA
93105-4339
US

IV. Provider business mailing address

2320 BATH ST
SANTA BARBARA CA
93105-4339
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7984
  • Fax: 805-569-2964
Mailing address:
  • Phone: 805-682-7984
  • Fax: 805-569-2964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33907
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: