| Associated Neurology Medical Group, Inc. | |
|
365 Hawthorne Ave Suite 203 Oakland CA 94609-3107 | |
| (510) 834-5778 | |
| Not Available |
| Full Name | Associated Neurology Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 365 Hawthorne Ave, Oakland, California |
| Authorized Official Name and Position | Randall Robert Starkey (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 5108345778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Associated Neurology Medical Group, Inc. 365 Hawthorne Ave Suite 203 Oakland CA 94609-3107 Ph: (510) 834-5778 | Associated Neurology Medical Group, Inc. 365 Hawthorne Ave Suite 203 Oakland CA 94609-3107 Ph: (510) 834-5778 |
| NPI Number | 1922205442 |
|---|---|
| Provider Enumeration Date | 06/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922205442 | NPI | - | NPPES |
| GR0017862 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | C1233914 (California) | Primary |
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