Provider Demographics
NPI:1275646721
Name:WEINGARD, HERBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:B
Last Name:WEINGARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13851 E 14TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2631
Mailing Address - Country:US
Mailing Address - Phone:510-351-2100
Mailing Address - Fax:510-357-3389
Practice Address - Street 1:13851 E 14TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2631
Practice Address - Country:US
Practice Address - Phone:510-351-2100
Practice Address - Fax:510-357-3389
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG24892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA42435Medicare UPIN
CA00G248920Medicare PIN