Provider Demographics
NPI:1346288545
Name:WEISENBERG, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:WEISENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-2119
Mailing Address - Country:US
Mailing Address - Phone:650-323-7146
Mailing Address - Fax:650-324-8123
Practice Address - Street 1:805 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1734
Practice Address - Country:US
Practice Address - Phone:650-853-6600
Practice Address - Fax:650-853-2288
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10135174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist