| Dr Ronnie Isaac Mimran, MD | |
|
20055 Lake Chabot Rd, #110, Castro Valley, CA 94546 | |
| (510) 886-3138 | |
| (510) 373-1616 |
| Full Name | Dr Ronnie Isaac Mimran |
|---|---|
| Gender | Male |
| Speciality | Neurological Surgery |
| Location | 20055 Lake Chabot Rd, Castro Valley, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821043498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | A90574 (California) | Primary |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ronnie Isaac Mimran, MD 1320 El Capitan Dr, #300, Danville, CA 94526-6258 Ph: () - | Dr Ronnie Isaac Mimran, MD 20055 Lake Chabot Rd, #110, Castro Valley, CA 94546 Ph: (510) 886-3138 |
Dr. Lawrence David Dickinson, MD Neurological Surgery Medicare: Medicare Enrolled Practice Location: 20055 Lake Chabot Rd, # 110, Castro Valley, CA 94546 Phone: 510-886-3138 Fax: 510-373-1616 | |
Dr. Jeffrey Blaine Randall, MD Neurological Surgery Medicare: Accepting Medicare Assignments Practice Location: 20055 Lake Chabot Rd, # 110, Castro Valley, CA 94546 Phone: 510-886-3138 Fax: 510-373-1616 |