| |
13851 E 14th St Ste 102 San Leandro CA 94578-2628 | |
(510) 351-2100 | |
(510) 357-3389 |
Full Name | |
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Speciality | Family Medicine |
Location | 13851 E 14th St Ste 102, San Leandro, California |
Authorized Official Name and Position | Yvonne Bell (BUSINESS OFFICE) |
Authorized Official Contact | 5103512100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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13851 E 14th St Ste 102 San Leandro CA 94578-2628 Ph: (510) 351-2100 | 13851 E 14th St Ste 102 San Leandro CA 94578-2628 Ph: (510) 351-2100 |
NPI Number | 1225187339 |
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Provider Enumeration Date | 01/09/2007 |
Last Update Date | 06/17/2015 |
Medicare PECOS PAC ID | 5092740530 |
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Medicare Enrollment ID | O20051003000910 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225187339 | NPI | - | NPPES |
00G772110 | Other | CA | CALIFORNIA LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christi C Cheng |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982674685 PECOS PAC ID: 8921033416 Enrollment ID: I20051004000391 |
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