Provider Demographics
NPI:1144277492
Name:WEISSMAN, MARK A (DPM)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:DPM
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Other - First Name:
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Mailing Address - Street 1:8530 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3122
Mailing Address - Country:US
Mailing Address - Phone:310-659-6800
Mailing Address - Fax:310-657-0466
Practice Address - Street 1:8530 WILSHIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3122
Practice Address - Country:US
Practice Address - Phone:310-659-6800
Practice Address - Fax:310-657-0466
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4552213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist