Individual
TODD W. WEITZENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 571-4000
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
A64341
CA
208100000X
Physical Medicine & Rehabilitation Physician
A64341
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A643410
—
CA
Enumeration date
10/25/2006
Last updated
12/13/2021
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