MEDICARE: DR. R. STUART 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	G19422	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	:	1780612101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. R. STUART WEEKS M.D.

Provider Business Mailing Address
First Line	:	3590 CAMINO DEL RIO N
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1707
Country	:	US
Telephone Number	:	619-810-1000
Fax Number	:	619-229-4938

Provider Business Practice Location Address
First Line	:	3590 CAMINO DEL RIO N
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1707
Country	:	US
Telephone Number	:	619-810-1000
Fax Number	:	619-229-4938

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	04/03/2018

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