Dr. Jack Weinstein , MD
General Practice • Villa Park, CA
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jack Weinstein has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Jack Weinstein, MD was a registered General Practice practicing in Villa Park, CA. Throughout an active medical career spanning 3 years, Dr. Weinstein provided care at the practice location at 17853 SANTIAGO BLVD STE 107-354 until profile deactivation on 2020-04-20.
Practice Location & Contact Primary Location
17853 Santiago Blvd Ste 107-354
Villa Park, CA 928614113
Specialty Benchmarks & Practice Insights
Comparative analytics for General Practice in Villa Park, CA
Practicing in Villa Park, CA (2300 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 208D00000X
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on April 20, 2020
NPI status registered as active in NPPES database
Registered at 17853 SANTIAGO BLVD STE 107-354, VILLA PARK, CA 928614113 (Tel: 7143238082)
Registered at 17853 SANTIAGO BLVD STE 107-354, VILLA PARK, CA 928614113 (Tel: 7143238082)
Recorded as JACK WEINSTEIN, M.D.
General Practice (License #G21109 in CA)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
17853 Santiago Blvd Ste 107-354
Villa Park, CA 928614113
Phone: 7143238082
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