Provider Demographics
NPI:1033277231
Name:WEINTRAUB, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1240 S WESTLAKE BLVD
Mailing Address - Street 2:#102
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-496-7888
Mailing Address - Fax:805-496-7699
Practice Address - Street 1:1240 S WESTLAKE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-496-7888
Practice Address - Fax:805-496-7699
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG40636207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A48298Medicare UPIN
CAG40636AMedicare ID - Type Unspecified