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General NPI Number Information
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NPI Number | 1114321460
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Entity Type | Organization
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Legal Business Name | JUNE WEINSTEIN&ASSOCIATES LLC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 17853 SANTIAGO BLVD SUITE 354
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City | VILLA PARK
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State | CA
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Zip | 92861-4113
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Country | US
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Telephone | 714-974-3828
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Fax | 714-974-4461
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Provider Business Mailing Address
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Address Line | 17853 SANTIAGO BLVD SUITE 354
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City | VILLA PARK
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State | CA
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Zip | 92861-4113
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Country | US
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Telephone | 714-974-3828
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Fax | 714-974-4461
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Authorized Official
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Title or Position | CFO AND MEDICAL CONSULTANT
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Name | DR. JACK NMN WEINSTEIN
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Credential | M.D.
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Telephone | 714-323-8082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G21109
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License Number State | CA
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