International Pediatric Medical Group INC
Pediatrics in Oakland, CA. Organization (NPI-2).
NPI number1861591752
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1861591752
- Entity type
- Organization (NPI-2)
- Legal business name
- International Pediatric Medical Group INC
- Organization subpart
- No
- Enumeration date
- Sep 21, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | A67904 | CA | Yes |
Practice location
600 International Blvd#102
Oakland, CA 94606
Phone 510-208-3540 · Fax 510-208-3553
Mailing address
600 International Blvd#102
Oakland, CA 94606
Phone 510-208-3540 · Fax 510-208-3553
Authorized official
An Tan Pham
MD
5102083540
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