Provider Demographics
NPI:1518060573
Name:WEIMER, SANFORD ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:ROY
Last Name:WEIMER
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 1:1530 E CHEVY CHASE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4139
Mailing Address - Country:US
Mailing Address - Phone:323-662-5798
Mailing Address - Fax:818-551-1152
Practice Address - Street 1:1530 E CHEVY CHASE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4139
Practice Address - Country:US
Practice Address - Phone:323-662-5798
Practice Address - Fax:818-551-1152
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG173842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry