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Contact Information

EMERYVILLE MULTISPECIALTY MEDICAL GROUP PROFESSIONAL CORPORATION
501 S SHORE CTR W
SUITE 103C
ALAMEDA, CA94501-5762
 Phone: 510-769-1118
 Fax: 510-769-1119
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Independent Medical Examiner

202C00000X
Indicates primary specialty

NPI Profile & details for EMERYVILLE MULTISPECIALTY MEDICAL GROUP PROFESSIONAL CORPORATION

NPI Number 1255536173
LBN Legal business name EMERYVILLE MULTISPECIALTY MEDICAL GROUP PROFESSIONAL CORPORATION
Authorized official JAMES KONG - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2007
Last updated 12/07/2012 - About 13 years ago
Identifiers
CA License # A76128
CA License # A84509
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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