Provider Demographics
NPI:1407921109
Name:WEINGARTEN, ZELMAN (MD)
Entity Type:Individual
Prefix:
First Name:ZELMAN
Middle Name:
Last Name:WEINGARTEN
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 1:605 S ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3817
Mailing Address - Country:US
Mailing Address - Phone:323-490-7365
Mailing Address - Fax:323-490-7363
Practice Address - Street 1:101 E BEVERLY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4315
Practice Address - Country:US
Practice Address - Phone:323-490-7365
Practice Address - Fax:323-490-7363
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26589207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1538391545Medicaid
A24894Medicare UPIN
CAS051186Medicare PIN