Provider Demographics
NPI:1366556102
Name:WEINSTEIN, STEPHEN GERALD (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GERALD
Last Name:WEINSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LA CASA VIA
Mailing Address - Street 2:100
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4863
Mailing Address - Country:US
Mailing Address - Phone:925-932-2565
Mailing Address - Fax:925-930-8568
Practice Address - Street 1:240 LA CASA VIA
Practice Address - Street 2:100
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-4863
Practice Address - Country:US
Practice Address - Phone:925-932-2565
Practice Address - Fax:925-930-8568
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18806207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ73673ZMedicaid
CAZZZ73673ZMedicare ID - Type Unspecified
CAZZZ73673ZMedicaid