Provider Demographics
NPI:1518205012
Name:WEINGARTEN, NAFTOLI (DPM)
Entity Type:Individual
Prefix:DR
First Name:NAFTOLI
Middle Name:
Last Name:WEINGARTEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E SAN ANTONIO DR
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2211
Mailing Address - Country:US
Mailing Address - Phone:562-774-3668
Mailing Address - Fax:
Practice Address - Street 1:901 E SAN ANTONIO DR
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2211
Practice Address - Country:US
Practice Address - Phone:562-774-3668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006529213ES0103X
CAE-5045213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery