Organization
JAMES D WEISS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTRY SETSER (PRES)
(800) 333-9800
Entity
Organization
Contact information
Practice address
624 FREDERICK ST, SANTA CRUZ, CA 95062-2203
(831) 427-3100
(831) 427-3131
Mailing address
624 FREDERICK ST, SANTA CRUZ, CA 95062-2203
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G36492
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5617432
OTHER ID NUMBER
—
Enumeration date
06/13/2006
Last updated
01/02/2008
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