| East Bay Family Practice Medical Group Inc | |
|
3100 Telegraph Ave Ste 2109 Oakland CA 94609-3210 | |
| (510) 645-9900 | |
| (510) 645-9919 |
| Full Name | East Bay Family Practice Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3100 Telegraph Ave, Oakland, California |
| Authorized Official Name and Position | Audrey D'andrea (VICE PRESIDENT SHARE HOLDER) |
| Authorized Official Contact | 5106459900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Bay Family Practice Medical Group Inc 3100 Telegraph Ave Ste 2109 Oakland CA 94609-3210 Ph: (510) 645-9900 | East Bay Family Practice Medical Group Inc 3100 Telegraph Ave Ste 2109 Oakland CA 94609-3210 Ph: (510) 645-9900 |
| NPI Number | 1154313237 |
|---|---|
| Provider Enumeration Date | 08/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154313237 | NPI | - | NPPES |
| GR0003490 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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