Provider Demographics
NPI:1609834241
Name:WEINSTEIN, ROBERT STUART (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:STUART
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#12 DEL AMO FASHION CENTER
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-542-3531
Mailing Address - Fax:310-542-3570
Practice Address - Street 1:#12 DEL AMO FASHION CENTER
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-542-3531
Practice Address - Fax:310-542-3570
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT4918152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U10504OtherUPIN
CAWOP4918BMedicare PIN