| Medical Doctors Group, Inc | |
|
433 Estudillo Ave Ste 206 San Leandro CA 94577-4915 | |
| (510) 969-4166 | |
| (510) 969-5530 |
| Full Name | Medical Doctors Group, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 433 Estudillo Ave Ste 206, San Leandro, California |
| Authorized Official Name and Position | Ernest Lincoln Bonner (CEO) |
| Authorized Official Contact | 5108471581 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Doctors Group, Inc 2014 Santa Clara Ave Alameda CA 94501-2721 Ph: (510) 847-1581 | Medical Doctors Group, Inc 433 Estudillo Ave Ste 206 San Leandro CA 94577-4915 Ph: (510) 969-4166 |
| NPI Number | 1407237159 |
|---|---|
| Provider Enumeration Date | 06/17/2015 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 0446550214 |
|---|---|
| Medicare Enrollment ID | O20151130001937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407237159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A30477 (California) | Primary |
| Provider Name | Ernest Lincoln Bonner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992785703 PECOS PAC ID: 3971500034 Enrollment ID: I20061102000221 |
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