Basic Information
| Provider Information | |||||||||
| NPI: | 1023057833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEEKES | ||||||||
| FirstName: | ARNOLD | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 DISTEL CIR | ||||||||
| Address2: | |||||||||
| City: | LOS ALTOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940221408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257563400 | ||||||||
| FaxNumber: | 9257563410 | ||||||||
| Practice Location | |||||||||
| Address1: | 4053 LONE TREE WAY STE 201 | ||||||||
| Address2: | |||||||||
| City: | ANTIOCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945316210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257563400 | ||||||||
| FaxNumber: | 9257563410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 07/31/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 775521 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | A88042 | 01 | CA | STATE MEDICAL LICENSE | OTHER | RHC00166977 | 01 | CA | FLOUROSCOPY CERTIFCATION | OTHER | 1023057833 | 05 | CA | MEDICAID |