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2201 Broadway Ste 101 Oakland CA 94612-3028 | |
(510) 473-8700 | |
(510) 473-8081 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 2201 Broadway Ste 101, Oakland, California |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 6154686270 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 2201 Broadway Ste 101 Oakland CA 94612-3028 Ph: (510) 473-8700 |
NPI Number | 1356095467 |
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Provider Enumeration Date | 02/08/2022 |
Last Update Date | 10/24/2024 |
Identifier | Type | State | Issuer |
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1356095467 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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