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General NPI Number Information
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NPI Number | 1922292994
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Entity Type | Organization
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Legal Business Name | WEISSMAN & STONE MED GRP, INC., A PROFESSINAL CORPORATION
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 08/31/2007
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Provider Practice Location Address
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Address Line | 39009 PALACE DR
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City | PALM DESERT
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State | CA
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Zip | 92211-7155
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Country | US
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Telephone | 760-641-4359
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Fax | 760-641-4359
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Provider Business Mailing Address
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Address Line | 39009 PALACE DR
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City | PALM DESERT
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State | CA
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Zip | 92211-7155
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Country | US
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Telephone | 760-641-4359
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Fax | 760-641-4359
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. ADAM WEISSMAN
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Credential | M.D.
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Telephone | 760-641-4359
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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 | A74030
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License Number State | CA
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