Provider Demographics
NPI:1487667366
Name:WEINBERG, MIKEL DAY (MD)
Entity Type:Individual
Prefix:DR
First Name:MIKEL
Middle Name:DAY
Last Name:WEINBERG
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 1:700 SECOND ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-942-0716
Mailing Address - Fax:760-634-7746
Practice Address - Street 1:700 SECOND ST
Practice Address - Street 2:SUITE H
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024
Practice Address - Country:US
Practice Address - Phone:760-942-0716
Practice Address - Fax:760-634-7746
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG253152084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG25315Medicare ID - Type Unspecified
A90935Medicare UPIN