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Individual

DR. RICHARD A WEISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
607 N CENTRAL AVE, SUITE 105, GLENDALE, CA 91203-1804
(818) 956-1010
(818) 543-6083
Mailing address
607 N CENTRAL AVE, SUITE 204, GLENDALE, CA 91203-1804
(818) 956-1010
(818) 543-6083

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G45111
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZZ75843Z
CA
Enumeration date
10/11/2005
Last updated
09/23/2013
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