Healthcare Provider Details

I. General information

NPI: 1619049491
Provider Name (Legal Business Name): JOHN MUIR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 GRANT ST
CONCORD CA
94520-2266
US

IV. Provider business mailing address

2700 GRANT ST
CONCORD CA
94520-2266
US

V. Phone/Fax

Practice location:
  • Phone: 925-674-2637
  • Fax: 925-674-2635
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY42917
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY42917
License Number StateCA

VIII. Authorized Official

Name: MICHAEL THOMAS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 925-941-2100