| Blackhawk Center For Digestive Health | |
|
111 Deerwood Rd Suite 168 San Ramon CA 94583-4409 | |
| (925) 736-8228 | |
| (925) 736-8882 |
| Full Name | Blackhawk Center For Digestive Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 Deerwood Rd, San Ramon, California |
| Authorized Official Name and Position | Jeffrey C. G. Mark (PHYSICIAN) |
| Authorized Official Contact | 9257368228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackhawk Center For Digestive Health 111 Deerwood Rd Suite 168 San Ramon CA 94583-4409 Ph: (925) 736-8228 | Blackhawk Center For Digestive Health 111 Deerwood Rd Suite 168 San Ramon CA 94583-4409 Ph: (925) 736-8228 |
| NPI Number | 1538367818 |
|---|---|
| Provider Enumeration Date | 07/06/2007 |
| Last Update Date | 01/10/2012 |
| Medicare PECOS PAC ID | 0840351466 |
|---|---|
| Medicare Enrollment ID | O20081201000692 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538367818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | G83524 (California) | Primary |
| Provider Name | Jeffrey C.g. Mark |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487603155 PECOS PAC ID: 8628080421 Enrollment ID: I20081201000681 |
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