| Alliance Hospitalist Medical Group Inc | |
|
215 W Janss Rd Thousand Oaks CA 91360-1847 | |
| (805) 497-1800 | |
| Not Available |
| Full Name | Alliance Hospitalist Medical Group Inc |
|---|---|
| Speciality | Hospitalist |
| Location | 215 W Janss Rd, Thousand Oaks, California |
| Authorized Official Name and Position | Geoffrey Lee Graham (PRESIDENT) |
| Authorized Official Contact | 8054971810 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Hospitalist Medical Group Inc 1534 N Moorpark Rd # 291 Thousand Oaks CA 91360-5129 Ph: (805) 497-1810 | Alliance Hospitalist Medical Group Inc 215 W Janss Rd Thousand Oaks CA 91360-1847 Ph: (805) 497-1800 |
| NPI Number | 1720187230 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 10/12/2017 |
| Medicare PECOS PAC ID | 3274568621 |
|---|---|
| Medicare Enrollment ID | O20051004000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720187230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G39820 (California) | Secondary |
| 208M00000X | Hospitalist | G39820 (California) | Primary |
| Provider Name | Geoffrey L Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356343073 PECOS PAC ID: 3779470810 Enrollment ID: I20040302001448 |
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