| Stephen Weisberg Dds Inc | |
|
11600 Wilshire Blvd Suite 520 Los Angeles CA 90025-5781 | |
| (310) 444-9900 | |
| (310) 444-9928 |
| Full Name | Stephen Weisberg Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 11600 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Stephen Weisberg (OWNER) |
| Authorized Official Contact | 3104449900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen Weisberg Dds Inc 11600 Wilshire Blvd Suite 520 Los Angeles CA 90025-5781 Ph: (310) 444-9900 | Stephen Weisberg Dds Inc 11600 Wilshire Blvd Suite 520 Los Angeles CA 90025-5781 Ph: (310) 444-9900 |
| NPI Number | 1679756464 |
|---|---|
| Provider Enumeration Date | 12/14/2007 |
| Last Update Date | 12/14/2007 |
| Medicare PECOS PAC ID | 1254421662 |
|---|---|
| Medicare Enrollment ID | O20071220000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679756464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | CA 017210 (California) | Primary |
| Provider Name | Stephen Weisberg |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1760589618 PECOS PAC ID: 8527158930 Enrollment ID: I20071220000718 |
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