MEDICARE: DR. JOHN CHAMBERS GOOD MD

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	207Q00000X	Family Medicine Physician	G21825	CA

General Provider Information

NPI Number	:	1629041769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CHAMBERS GOOD MD

Provider Business Mailing Address
First Line	:	3100 TELEGRAPH AVE
Second Line	:	SUITE 2102
City	:	OAKLAND
State	:	CA
Zip	:	94609-3210
Country	:	US
Telephone Number	:	810-286-8160
Fax Number	:	510-286-8158

Provider Business Practice Location Address
First Line	:	3100 TELEGRAPH AVE
Second Line	:	SUITE 2102
City	:	OAKLAND
State	:	CA
Zip	:	94609-3210
Country	:	US
Telephone Number	:	810-286-8160
Fax Number	:	510-286-8158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	05/13/2008

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