Provider Demographics
NPI:1750746269
Name:WEISS, DEAN HILLEL (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:HILLEL
Last Name:WEISS
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 1:16060 VENTURA BLVD
Mailing Address - Street 2:SUITE 110 - 124
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2761
Mailing Address - Country:US
Mailing Address - Phone:310-437-3407
Mailing Address - Fax:310-388-0616
Practice Address - Street 1:16060 VENTURA BLVD
Practice Address - Street 2:SUITE 110 - 124
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2761
Practice Address - Country:US
Practice Address - Phone:310-437-3407
Practice Address - Fax:310-388-0616
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65814207R00000X, 213EP0504X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine