Provider Demographics
NPI:1376686279
Name:WEISS, JEROME M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:M
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:490 POST STREET, SUITE 1100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-441-5800
Mailing Address - Fax:415-441-4946
Practice Address - Street 1:490 POST STREET, SUITE 1100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-441-5800
Practice Address - Fax:415-441-4946
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG7272208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG7272OtherSTATE LICENSE #
CAG7272OtherSTATE LICENSE #
CAA57821Medicare UPIN