Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | G39051 | CA |
NPI | 1710939681 |
---|---|
Provider Name | Dr. Carl Weinert |
First Address | Orange, CA 92868-3854 |
Second Address | Orange, CA 92868-3854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 11/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G390510 | (05) | CA |
00G390511 | MEDI-CAL LEGACY (01) | CA |
A47987 | (02) | CA |
W14179 | GROUP PTAN (01) | CA |
WG39051A | MEDICARE PTAN (01) | CA |