Provider Demographics
NPI:1972780641
Name:WEINBERG, JEFFREY M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:WEINBERG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1950 SAWTELLE BLVD
Mailing Address - Street 2:SUITE 335
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7014
Mailing Address - Country:US
Mailing Address - Phone:310-477-9997
Mailing Address - Fax:206-666-2027
Practice Address - Street 1:1950 SAWTELLE BLVD
Practice Address - Street 2:SUITE 335
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7014
Practice Address - Country:US
Practice Address - Phone:310-477-9997
Practice Address - Fax:206-666-2027
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG0354682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
EO2626Medicare UPIN