Provider Demographics
NPI:1164794210
Name:MICHAEL P WEINSTEIN, MD INC.
Entity Type:Organization
Organization Name:MICHAEL P WEINSTEIN, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-759-3600
Mailing Address - Street 1:360 SAN MIGUEL DR STE 701
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5927
Mailing Address - Country:US
Mailing Address - Phone:949-759-3600
Mailing Address - Fax:949-758-0282
Practice Address - Street 1:360 SAN MIGUEL DR STE 701
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5927
Practice Address - Country:US
Practice Address - Phone:949-759-3600
Practice Address - Fax:949-758-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG054621174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52758Medicare UPIN