Provider Demographics
NPI:1144413857
Name:STEVEN R. WEINSTEIN, M.D., INC.
Entity Type:Organization
Organization Name:STEVEN R. WEINSTEIN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-543-1329
Mailing Address - Street 1:4201 TORRANCE BLVD STE 750
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4520
Mailing Address - Country:US
Mailing Address - Phone:310-540-1953
Mailing Address - Fax:310-792-1974
Practice Address - Street 1:4201 TORRANCE BLVD STE 750
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4520
Practice Address - Country:US
Practice Address - Phone:310-540-1953
Practice Address - Fax:310-792-1974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-26
Last Update Date:2007-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19079174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G190790Medicaid
CA00G190790Medicaid
CAG19079Medicare PIN