MEDICARE: DR. ELIZABETH WEINBERGER PH.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY8455	CA

General Provider Information

NPI Number	:	1043279912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH WEINBERGER PH.D., M.P.H.

Provider Business Mailing Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	STE 301
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	310-828-3624
Fax Number	:	310-820-8839

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	STE 301
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5379
Country	:	US
Telephone Number	:	310-828-3624
Fax Number	:	310-820-8839

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	10/05/2019

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