Provider Demographics
NPI:1730296443
Name:WEINBERG, LAWRENCE ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALEXANDER
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:18433 ROSCOE BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4108
Mailing Address - Country:US
Mailing Address - Phone:818-349-2503
Mailing Address - Fax:818-349-4724
Practice Address - Street 1:18433 ROSCOE BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4108
Practice Address - Country:US
Practice Address - Phone:818-349-2503
Practice Address - Fax:818-349-4724
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG705912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ78006ZMedicaid
CAW3189Medicare PIN
CAE90614Medicare UPIN