| Infectious Disease Medical Group | |
|
5601 Norris Canyon Rd Suite 210 San Ramon CA 94583-5407 | |
| (925) 867-3829 | |
| (925) 867-3820 |
| Full Name | Infectious Disease Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 5601 Norris Canyon Rd, San Ramon, California |
| Authorized Official Name and Position | Benedict Villanueva (CEO) |
| Authorized Official Contact | 9258673829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Medical Group 5601 Norris Canyon Rd Suite 210 San Ramon CA 94583-5407 Ph: (925) 867-3829 | Infectious Disease Medical Group 5601 Norris Canyon Rd Suite 210 San Ramon CA 94583-5407 Ph: (925) 867-3829 |
| NPI Number | 1154446425 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6608069034 |
|---|---|
| Medicare Enrollment ID | O20101019000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154446425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A61699 (California) | Primary |
| Provider Name | Benedict Cortez Villanueva |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1376601690 PECOS PAC ID: 7416140843 Enrollment ID: I20101019000264 |
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