Provider Demographics
NPI:1023004116
Name:WEINSTEIN, JOEL ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:ANDREW
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1885
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95077-1885
Mailing Address - Country:US
Mailing Address - Phone:831-722-4300
Mailing Address - Fax:831-768-6261
Practice Address - Street 1:75 NIELSON ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-2468
Practice Address - Country:US
Practice Address - Phone:831-722-4300
Practice Address - Fax:831-768-6261
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG49173208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G491730Medicaid
CAG491730OtherLICENSE
CA00G491730OtherBLUE SHIELD
CA00G491730Medicaid