Individual
IRWIN KEVIN WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVENUE, 12-441 MDCC, LOS ANGELES, CA 90095
(310) 206-3952
(310) 206-0209
Mailing address
10833 LE CONTE AVENUE, 12-441 MDCC, LOS ANGELES, CA 90095
(310) 206-3952
(310) 206-0209
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
G74628
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
G74628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G746280
—
CA
05
—
GR0053510
—
CA
Enumeration date
09/15/2006
Last updated
08/30/2011
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