Healthcare Provider Details

I. General information

NPI: 1659513901
Provider Name (Legal Business Name): ALLIANCE MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 OAK HILL RD FL 3
LAFAYETTE CA
94549-3869
US

IV. Provider business mailing address

1009 OAK HILL RD FL 3
LAFAYETTE CA
94549-3869
US

V. Phone/Fax

Practice location:
  • Phone: 925-299-8000
  • Fax:
Mailing address:
  • Phone: 925-299-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberC39876
License Number StateCA

VIII. Authorized Official

Name: DR. EDWARD G FESS
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 925-299-8000