MEDICARE: DAVID MARK WEINBERG 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	G62688	CA

General Provider Information

NPI Number	:	1518964105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MARK WEINBERG MD

Provider Business Mailing Address
First Line	:	3080 BRISTOL STREET
Second Line	:	SUITE 150
City	:	COSTA MESA
State	:	CA
Zip	:	92626-7341
Country	:	US
Telephone Number	:	714-445-0220
Fax Number	:	714-445-0245

Provider Business Practice Location Address
First Line	:	1041 E YORBA LINDA BLVD STE 101
Second Line	:
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3762
Country	:	US
Telephone Number	:	714-445-0220
Fax Number	:	714-445-0245

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	07/27/2017

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