Provider Demographics
NPI:1043633803
Name:MD WEIGHT MANAGEMENT, INC.
Entity Type:Organization
Organization Name:MD WEIGHT MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-674-5200
Mailing Address - Street 1:2340 CLAY ST FL 6
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1932
Mailing Address - Country:US
Mailing Address - Phone:415-674-5200
Mailing Address - Fax:415-600-3705
Practice Address - Street 1:2340 CLAY ST FL 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1932
Practice Address - Country:US
Practice Address - Phone:415-674-5200
Practice Address - Fax:415-600-3705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Multi-Specialty