Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | C34355 | CA |
NPI | 1003875816 |
---|---|
Provider Name | Richard A Weinberg |
First Address | Fresno, CA 93720-3342 |
Second Address | Fresno, CA 93720-3342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 15/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C34550 | (05) | CA |
040003645 | RAILROAD MEDICARE (01) | CA |
A35594 | (02) | CA |