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General NPI Number Information
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NPI Number | 1306888185
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Entity Type | Organization
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Legal Business Name | JAMES D WEISS MD
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 624 FREDERICK ST
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City | SANTA CRUZ
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State | CA
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Zip | 95062-2203
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Country | US
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Telephone | 831-427-3100
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Fax | 831-427-3131
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Provider Business Mailing Address
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Address Line | 624 FREDERICK ST
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City | SANTA CRUZ
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State | CA
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Zip | 95062-2203
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DESTRY SETSER
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Credential |
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Telephone | 800-333-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | G36492
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License Number State | CA
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