Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | G058350 | CA |
NPI | 1891028791 |
---|---|
Provider Name | Dr. Susan Beth Weinstock |
First Address | Del Mar, CA 92014-4247 |
Second Address | Del Mar, CA 92014-4247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2009 |
Last Update Date | 09/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BW7331464 | DEA (01) |