Provider Demographics
NPI:1295044717
Name:WEIL EYE CARE MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:WEIL EYE CARE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-654-2133
Mailing Address - Street 1:1008 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-3919
Mailing Address - Country:US
Mailing Address - Phone:650-654-2133
Mailing Address - Fax:650-654-2170
Practice Address - Street 1:1008 LAUREL ST
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-3919
Practice Address - Country:US
Practice Address - Phone:650-654-2133
Practice Address - Fax:650-654-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80014174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty