Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A82871 | CA |
N | 111NI0900X | Internist | A82871 | CA |
N | 207RC0200X | Critical Care Medicine | A82871 | CA |
Y | 207RP1001X | Pulmonary Disease | A82871 | CA |
NPI | 1063617116 |
---|---|
Provider Name | Stephen Samuel Weigt |
First Address | Los Angeles, CA 90045-5632 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 28/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A828710 | (05) | CA |