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General NPI Number Information
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NPI Number | 1700150794
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Entity Type | Organization
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Legal Business Name | NOAH D. WEISS, MD INC
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 462 W NAPA ST STE A
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City | SONOMA
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State | CA
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Zip | 95476-6519
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Country | US
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Telephone | 707-935-5600
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Fax | 707-935-5606
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Provider Business Mailing Address
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Address Line | DEPT LA 24687
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City | PASADENA
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State | CA
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Zip | 91185-4687
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Country | US
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Telephone | 707-935-5600
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Fax | 707-935-5606
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Authorized Official
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Title or Position | OWNER
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Name | NOAH WEISS
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Credential | MD
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Telephone | 707-935-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G70397
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License Number State | CA
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