Basic Information
Provider Information
NPI: 1053581900
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEEKS
FirstName: DAVID
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 45123
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941450000
CountryCode: US
TelephoneNumber: 2099567725
FaxNumber: 2099567733
Practice Location
Address1: 2755 HERNDON AVENUE
Address2:  
City: CLOVIS
State: CA
PostalCode: 936126800
CountryCode: US
TelephoneNumber: 5593244000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/06/2008
LastUpdateDate: 01/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA102407CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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