| Tassajara Valley Medical Group Pc | |
|
1258 Concannon Blvd Livermore CA 94550-6002 | |
| (925) 443-8040 | |
| (925) 443-1065 |
| Full Name | Tassajara Valley Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1258 Concannon Blvd, Livermore, California |
| Authorized Official Name and Position | Raafat K Zamary (PRESIDENT) |
| Authorized Official Contact | 9254438040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tassajara Valley Medical Group Pc 1258 Concannon Blvd Livermore CA 94550-6002 Ph: (925) 443-8040 | Tassajara Valley Medical Group Pc 1258 Concannon Blvd Livermore CA 94550-6002 Ph: (925) 443-8040 |
| NPI Number | 1134179237 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134179237 | NPI | - | NPPES |
| GR0091680 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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