| Internal Medicine Associates Of Berkeley, A Medical Corporation | |
|
2320 Woolsey St Suite 201 Berkeley CA 94705-1973 | |
| (510) 843-8002 | |
| (510) 540-4808 |
| Full Name | Internal Medicine Associates Of Berkeley, A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 2320 Woolsey St, Berkeley, California |
| Authorized Official Name and Position | Andrew Jay Ross (PRESIDENT) |
| Authorized Official Contact | 5108438002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Associates Of Berkeley, A Medical Corporation Po Box 1440 Suisun City CA 94585-4440 Ph: (415) 493-3300 | Internal Medicine Associates Of Berkeley, A Medical Corporation 2320 Woolsey St Suite 201 Berkeley CA 94705-1973 Ph: (510) 843-8002 |
| NPI Number | 1457457608 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 03/18/2014 |
| Medicare PECOS PAC ID | 5193638369 |
|---|---|
| Medicare Enrollment ID | O20031112000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457457608 | NPI | - | NPPES |
| GR0103300 | Other | CA | MEDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ZZZ27095Z (California) | Primary |
| Provider Name | Andrew J Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710919931 PECOS PAC ID: 2163335332 Enrollment ID: I20031117000362 |
| Provider Name | Deborah L De Mott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124040084 PECOS PAC ID: 6901710722 Enrollment ID: I20031117000413 |
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