MEDICARE: ISAAC WIENER MD

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	207RC0000X	Cardiovascular Disease Physician	G46722	CA
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	G46722	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	:	1427041078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC WIENER MD

Provider Business Mailing Address
First Line	:	16542 VENTURA BLVD STE 402
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-4562
Country	:	US
Telephone Number	:	818-782-5041
Fax Number	:	818-205-9091

Provider Business Practice Location Address
First Line	:	10921 WILSHIRE BLVD STE 1205
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4005
Country	:	US
Telephone Number	:	310-824-3378
Fax Number	:	310-208-2870

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	08/12/2022

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Directions to “ ISAAC WIENER MD” Practice Location

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