Provider Demographics
NPI:1457569162
Name:WEISS, STEVEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:WEISS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11480 BROOKSHIRE AV
Mailing Address - Street 2:#107
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-5003
Mailing Address - Country:US
Mailing Address - Phone:562-861-0897
Mailing Address - Fax:310-659-6237
Practice Address - Street 1:11480 BROOKSHIRE AV
Practice Address - Street 2:#107
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-5003
Practice Address - Country:US
Practice Address - Phone:562-861-0897
Practice Address - Fax:310-659-6237
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2008-03-07
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Provider Licenses
StateLicense IDTaxonomies
CAG39288207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47771Medicare UPIN