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3706 Telegraph Ave Oakland CA 94609-2418 | |
(510) 375-2836 | |
(510) 653-7159 |
Full Name | |
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Speciality | General Practice |
Location | 3706 Telegraph Ave, Oakland, California |
Authorized Official Name and Position | Edward Sanders (PRESIDENT) |
Authorized Official Contact | 5103752836 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2270 Sausalito CA 94966-2270 Ph: (510) 331-2788 | 3706 Telegraph Ave Oakland CA 94609-2418 Ph: (510) 375-2836 |
NPI Number | 1275757015 |
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Provider Enumeration Date | 04/12/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1275757015 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | C29998 (California) | Primary |
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