| Independence Health | |
|
140 Stanbridge Ln Alameda CA 94502-7420 | |
| (919) 622-8272 | |
| (844) 324-0805 |
| Full Name | Independence Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 140 Stanbridge Ln, Alameda, California |
| Authorized Official Name and Position | Benard Bennet (OWNER) |
| Authorized Official Contact | 9196228272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Health 140 Stanbridge Ln Alameda CA 94502-7420 Ph: (919) 622-8272 | Independence Health 140 Stanbridge Ln Alameda CA 94502-7420 Ph: (919) 622-8272 |
| NPI Number | 1669942751 |
|---|---|
| Provider Enumeration Date | 11/30/2018 |
| Last Update Date | 11/30/2018 |
| Medicare PECOS PAC ID | 0042549966 |
|---|---|
| Medicare Enrollment ID | O20190901000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669942751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bernard L Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871568899 PECOS PAC ID: 6507754835 Enrollment ID: I20151012001018 |
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