Organization
MARK S WEINTRAUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WEINTRAUB O.D. (OPTOMETRIST)
(310) 394-1011
Entity
Organization
Contact information
Practice address
1355 4TH ST, SANTA MONICA, CA 90401-1301
(310) 394-1011
Mailing address
1355 4TH ST, SANTA MONICA, CA 90401-1301
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0622410001
DME SUPPLIER ID
CA
Enumeration date
01/12/2007
Last updated
08/22/2020
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