Provider Demographics
NPI:1902844160
Name:WEISS, RHONDA A (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:A
Last Name:WEISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 KAISER DR
Mailing Address - Street 2:BLDG A
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5061
Mailing Address - Country:US
Mailing Address - Phone:408-851-9200
Mailing Address - Fax:
Practice Address - Street 1:2885 KAISER DR
Practice Address - Street 2:BLDG A
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5061
Practice Address - Country:US
Practice Address - Phone:408-851-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80458208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A80450Medicare ID - Type Unspecified
I02979Medicare UPIN