MEDICARE: DR. DONALD H WEISS 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	207Q00000X	Family Medicine Physician	C25184	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	:	1780770560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD H WEISS MD

Provider Business Mailing Address
First Line	:	3811 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1020
Country	:	US
Telephone Number	:	619-284-5622
Fax Number	:	619-284-3160

Provider Business Practice Location Address
First Line	:	3811 EL CAJON BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1020
Country	:	US
Telephone Number	:	619-284-5622
Fax Number	:	619-284-3160

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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