Organization
FREDRIC E WEISS INC
Active
Organization
FREDRIC E WEISS INC
Active
Parent organization
FREDRIC E. WEISS M.D. INC.
Other names
Fredric E. Weiss M.D. Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDRIC E. WEISS M.D. INC.
Authorized official
MRS. KATHY WEISS (OFFICE MANAGER)
(818) 501-4277
Entity
Organization
Contact information
Practice address
16311 VENTURA BLVD, 1175, ENCINO, CA 91436-4359
(818) 501-4277
(818) 501-3113
Mailing address
16311 VENTURA BLVD, 1175, ENCINO, CA 91436-4359
(818) 501-4277
(818) 501-3113
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G29963
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G299631
—
CA
01
—
G299631
BLUE SHIELD
CA
Enumeration date
07/24/2008
Last updated
12/19/2008
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