| |
616 16th St Suite 1 Oakland CA 94612-1205 | |
(510) 451-4270 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 616 16th St, Oakland, California |
Authorized Official Name and Position | Marty Lynch (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5104514270 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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616 16th St Suite 1 Oakland CA 94612-1205 Ph: (510) 451-4270 | 616 16th St Suite 1 Oakland CA 94612-1205 Ph: (510) 451-4270 |
NPI Number | 1093969420 |
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Provider Enumeration Date | 11/12/2008 |
Last Update Date | 06/18/2009 |
Identifier | Type | State | Issuer |
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1093969420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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