Provider Demographics
NPI:1366847014
Name:ANDREW R. WEYMER, MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ANDREW R. WEYMER, MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEYMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-485-7877
Mailing Address - Street 1:1700 N ROSE AVE
Mailing Address - Street 2:SUITE # 350
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3790
Mailing Address - Country:US
Mailing Address - Phone:805-485-7877
Mailing Address - Fax:805-981-4472
Practice Address - Street 1:1700 N ROSE AVE
Practice Address - Street 2:SUITE # 350
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3790
Practice Address - Country:US
Practice Address - Phone:805-485-7877
Practice Address - Fax:805-981-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB222254Medicare PIN