Healthcare Provider Details

I. General information

NPI: 1750391058
Provider Name (Legal Business Name): JAMES A. WEIDMAN, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE STE 270
WEST HILLS CA
91307-1470
US

IV. Provider business mailing address

7320 WOODLAKE AVE STE 270
WEST HILLS CA
91307-1470
US

V. Phone/Fax

Practice location:
  • Phone: 818-713-9377
  • Fax: 818-713-1924
Mailing address:
  • Phone: 818-713-9377
  • Fax: 818-713-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberG460760
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES ADAM WEIDMAN
Title or Position: PHYSICIAN OWNER
Credential: M.D. F.A.A. P.
Phone: 818-713-1977