1366516684 NPI number — HOWARD JAY WEISMAN MD PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366516684 NPI number — HOWARD JAY WEISMAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWARD JAY WEISMAN MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366516684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 GEARY RD
Provider Second Line Business Mailing Address:
HOWARD WEISMAN MD PC
Provider Business Mailing Address City Name:
PLEASANT HILL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-333-8520
Provider Business Mailing Address Fax Number:
925-287-9011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 GEARY RD
Provider Second Line Business Practice Location Address:
HOWARD WEISMAN MD PC
Provider Business Practice Location Address City Name:
PLEASANT HILL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-333-8520
Provider Business Practice Location Address Fax Number:
925-287-9011
Provider Enumeration Date:
11/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEISMAN
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
510-333-8520

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  C5042 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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