Provider Demographics
NPI:1922292994
Name:WEISSMAN & STONE MED GRP, INC., A PROFESSINAL CORPORATION
Entity Type:Organization
Organization Name:WEISSMAN & STONE MED GRP, INC., A PROFESSINAL CORPORATION
Other - Org Name:HEALTHPOINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-641-4359
Mailing Address - Street 1:39009 PALACE DR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-7155
Mailing Address - Country:US
Mailing Address - Phone:760-641-4359
Mailing Address - Fax:760-641-4359
Practice Address - Street 1:39009 PALACE DR
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-7155
Practice Address - Country:US
Practice Address - Phone:760-641-4359
Practice Address - Fax:760-641-4359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74030174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG86465Medicare UPIN
CAG82268Medicare UPIN