MEDICARE: HAL M. WEITZBUCH, M.D. 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	261QM2500X	Medical Specialty Clinic/Center	A121615	CA

General Provider Information

NPI Number	:	1639420177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAL M. WEITZBUCH, M.D. MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	23501 PARK SORRENTO STE 216
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1383
Country	:	US
Telephone Number	:	818-222-7495
Fax Number	:	818-222-7498

Provider Business Practice Location Address
First Line	:	23501 PARK SORRENTO STE 216
Second Line	:
City	:	CALABASAS
State	:	CA
Zip	:	91302-1383
Country	:	US
Telephone Number	:	818-222-7495
Fax Number	:	818-222-7498

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	JAN WEST
Credential	:
Telephone Number	:	818-222-7495

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	01/05/2026

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