Provider Demographics
NPI:1942311402
Name:WEINTRAUB, MARCIA K (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:K
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60790
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91116-6790
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:626-795-8247
Practice Address - Street 1:1328 22ND ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2032
Practice Address - Country:US
Practice Address - Phone:310-829-5511
Practice Address - Fax:310-829-8444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG65418207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFO986AMedicare PIN