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General NPI Number Information
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NPI Number | 1174693626
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Entity Type | Organization
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Legal Business Name | ASSA WEINBERG, MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6464 W SUNSET BLVD #1010
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City | LOS ANGELES
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State | CA
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Zip | 90028-8001
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Country | US
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Telephone | 323-461-5858
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Fax | 323-461-5852
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Provider Business Mailing Address
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Address Line | 6464 W SUNSET BLVD #1010
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City | LOS ANGELES
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State | CA
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Zip | 90028-8001
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Country | US
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Telephone | 323-461-5858
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Fax | 323-461-5852
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ASSA WEINBERG
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Credential | MD
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Telephone | 323-461-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C41889
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License Number State | CA
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