MEDICARE: ONE MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		WA
2	207Q00000X	Family Medicine Physician		WA

General Provider Information

NPI Number	:	1225550916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:

Provider Business Practice Location Address
First Line	:	747 6TH ST S
Second Line	:
City	:	KIRKLAND
State	:	WA
Zip	:	98033-6715
Country	:	US
Telephone Number	:	425-658-5298
Fax Number	:	206-315-1422

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW DIAMOND
Credential	:	MD
Telephone Number	:	415-658-6791

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/13/2023

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Directions to “ONE MEDICAL GROUP, INC. ” Practice Location

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