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General NPI Number Information
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NPI Number | 1174696215
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Entity Type | Organization
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Legal Business Name | DOT COM MEDICAL, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5706 CORSA AVE STE 200-O
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-4057
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Country | US
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Telephone | 800-400-4674
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Fax | 818-251-1112
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Provider Business Mailing Address
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Address Line | 20750 VENTURA BLVD STE 106
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-6647
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Country | US
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Telephone | 800-400-4674
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Fax | 818-251-1112
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Authorized Official
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Title or Position | COO
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Name | MR. JACK WEINBERG
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Credential |
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Telephone | 800-400-4674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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