Provider Demographics
NPI:1972522407
Name:WEINSTEIN, RICHARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:WEINSTEIN
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:PO BOX 9017
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-0917
Mailing Address - Country:US
Mailing Address - Phone:925-952-2888
Mailing Address - Fax:925-952-2845
Practice Address - Street 1:1656 N CALIFORNIA BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4180
Practice Address - Country:US
Practice Address - Phone:925-952-2888
Practice Address - Fax:925-952-2845
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC33113207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C331130Medicaid
CAA35166Medicare UPIN
CA00C331130Medicaid