Provider Demographics
NPI:1205924701
Name:WEINGARTEN, MOREY ABRAM (MD)
Entity type:Individual
Prefix:DR
First Name:MOREY
Middle Name:ABRAM
Last Name:WEINGARTEN
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 1:411 30TH ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3301
Mailing Address - Country:US
Mailing Address - Phone:510-836-2757
Mailing Address - Fax:
Practice Address - Street 1:411 30TH ST
Practice Address - Street 2:SUITE 412
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3301
Practice Address - Country:US
Practice Address - Phone:510-836-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG173852084P0800X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA40067Medicare UPIN
CA00G173851Medicare ID - Type Unspecified