| Peter J Weingold Md A Professional Corporation | |
|
12840 Riverside Dr Ste 208 Valley Village CA 91607-3343 | |
| (310) 854-0183 | |
| (310) 854-5631 |
| Full Name | Peter J Weingold Md A Professional Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12840 Riverside Dr Ste 208, Valley Village, California |
| Authorized Official Name and Position | Peter J Weingold (PRES.) |
| Authorized Official Contact | 3108540183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter J Weingold Md A Professional Corporation 12840 Riverside Dr Ste 208 Valley Village CA 91607-3343 Ph: (310) 854-0183 | Peter J Weingold Md A Professional Corporation 12840 Riverside Dr Ste 208 Valley Village CA 91607-3343 Ph: (310) 854-0183 |
| NPI Number | 1528339462 |
|---|---|
| Provider Enumeration Date | 01/24/2012 |
| Last Update Date | 10/17/2022 |
| Certification Date | 10/17/2022 |
| Medicare PECOS PAC ID | 7416115803 |
|---|---|
| Medicare Enrollment ID | O20120214000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528339462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G37195 (California) | Primary |
| Provider Name | Peter J Weingold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740202035 PECOS PAC ID: 8921266313 Enrollment ID: I20120222000119 |
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