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Individual

DR. CHARLES ERNEST WEIDMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15243 VANOWEN ST, SUITE 306, VAN NUYS, CA 91405-3649
(818) 781-0232
(818) 781-4132
Mailing address
15243 VANOWEN STREET, SUITE 306, VAN NUYS, CA 91405-3649
(818) 781-0232
(818) 781-4132

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G048620
CA
207RR0500X
Rheumatology Physician
Primary
G048620
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G486200
CA
Enumeration date
11/11/2005
Last updated
01/22/2015
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