Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 20A10747 | CA |
NPI | 1013113679 |
---|---|
Provider Name | Daniel Weingrow |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-1065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 13/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020A10747 | (05) | CA |