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General NPI Number Information
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NPI Number | 1104238518
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Entity Type | Organization
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Legal Business Name | DIANE WEISS, L.AC
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 890 HAMPSHIRE RD STE S
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-2875
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Country | US
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Telephone | 818-292-7061
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Fax | 805-379-2779
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Provider Business Mailing Address
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Address Line | 31514 FOXFIELD DR
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-4764
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Country | US
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Telephone | 818-292-7061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANE M WEISS
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Credential | L.AC
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Telephone | 818-292-7061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC15969
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License Number State | CA
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