| Misco Medical Group Inc | |
|
1125 Sir Francis Drake Blvd Kentfield CA 94904-1418 | |
| (877) 870-9301 | |
| (877) 882-0462 |
| Full Name | Misco Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1125 Sir Francis Drake Blvd, Kentfield, California |
| Authorized Official Name and Position | Jamison Derek Feramisco (CEO/OWNER) |
| Authorized Official Contact | 8778709301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Misco Medical Group Inc 31566 Railroad Canyon Rd 2-130 Canyon Lake CA 92587-9446 Ph: (877) 870-9301 | Misco Medical Group Inc 1125 Sir Francis Drake Blvd Kentfield CA 94904-1418 Ph: (877) 870-9301 |
| NPI Number | 1932469749 |
|---|---|
| Provider Enumeration Date | 05/25/2012 |
| Last Update Date | 05/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932469749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A105161 (California) | Primary |
Parnell Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1030 Sir Francis Drake Blvd, Suite 110, Kentfield, CA 94904 Phone: 415-461-1036 Fax: 415-461-1043 |