MEDICARE: ASSA WEINBERG, MD, A MEDICAL CORPORATION

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	207R00000X	Internal Medicine Physician	C41889	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174693626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSA WEINBERG, MD, A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	6464 W SUNSET BLVD
Second Line	:	#1010
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8001
Country	:	US
Telephone Number	:	323-461-5858
Fax Number	:	323-461-5852

Provider Business Practice Location Address
First Line	:	6464 W SUNSET BLVD
Second Line	:	#1010
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8001
Country	:	US
Telephone Number	:	323-461-5858
Fax Number	:	323-461-5852

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ASSA WEINBERG
Credential	:	MD
Telephone Number	:	323-461-5858

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	08/22/2020

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