Provider Demographics
NPI:1982725081
Name:WEISS, THOMAS ALFRED (PA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALFRED
Last Name:WEISS
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Gender:M
Credentials:PA
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Mailing Address - Street 1:350 POSADA LN
Mailing Address - Street 2:#102
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4059
Mailing Address - Country:US
Mailing Address - Phone:805-434-3699
Mailing Address - Fax:805-434-4864
Practice Address - Street 1:350 POSADA LN
Practice Address - Street 2:SUITE #102
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4059
Practice Address - Country:US
Practice Address - Phone:805-434-3699
Practice Address - Fax:805-434-4864
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA10320363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant