MEDICARE: DR. D. MICHAEL WEILL D.P.M.

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	213E00000X	Podiatrist	E2275	CA

General Provider Information

NPI Number	:	1043386980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. D. MICHAEL WEILL D.P.M.

Provider Business Mailing Address
First Line	:	13115 KESWICK ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1921
Country	:	US
Telephone Number	:	323-462-1491
Fax Number	:	323-285-5444

Provider Business Practice Location Address
First Line	:	13115 KESWICK ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-1921
Country	:	US
Telephone Number	:	323-462-1491
Fax Number	:	323-285-5444

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	09/19/2022

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