Provider Demographics
NPI:1811011794
Name:WEISBERG, LOUIS WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:WARREN
Last Name:WEISBERG
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 1:116 N ROBERTSON BLVD STE 803
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3111
Mailing Address - Country:US
Mailing Address - Phone:310-657-3540
Mailing Address - Fax:310-475-4330
Practice Address - Street 1:116 N ROBERTSON BLVD STE 803
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3111
Practice Address - Country:US
Practice Address - Phone:310-657-3540
Practice Address - Fax:310-475-4330
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG348892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry