MEDICARE: DR. BRIAN H. WEEKS M.D.

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	207Y00000X	Otolaryngology Physician	A77272	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	:	1639185234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN H. WEEKS M.D.

Provider Business Mailing Address
First Line	:	3590 CAMINO DEL RIO NORTH
Second Line	:	SUITE 102
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1716
Country	:	US
Telephone Number	:	619-810-1202
Fax Number	:	619-229-4938

Provider Business Practice Location Address
First Line	:	3590 CAMINO DEL RIO NORTH
Second Line	:	SUITE 102
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1716
Country	:	US
Telephone Number	:	619-810-1202
Fax Number	:	619-229-4938

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	09/15/2015

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