| Michael D. Delange Md Inc. | |
|
22298 Main St Hayward CA 94541-4005 | |
| (510) 881-1041 | |
| (510) 881-2178 |
| Full Name | Michael D. Delange Md Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 22298 Main St, Hayward, California |
| Authorized Official Name and Position | Michael D Delange (OWNER) |
| Authorized Official Contact | 5108811041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael D. Delange Md Inc. 22298 Main St Hayward CA 94541-4005 Ph: (510) 881-1041 | Michael D. Delange Md Inc. 22298 Main St Hayward CA 94541-4005 Ph: (510) 881-1041 |
| NPI Number | 1124293832 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 04/23/2008 |
| Medicare PECOS PAC ID | 7911893649 |
|---|---|
| Medicare Enrollment ID | O20040227000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124293832 | NPI | - | NPPES |
| 05D0598909 CA | Other | CA | MEDICARE |
| X74910 | Other | CA | CALIFORNIA UPIN |
| 00A703580 | Other | CA | CALIFORNIA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A070358 (California) | Primary |
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