Healthcare Provider Details

I. General information

NPI: 1215280805
Provider Name (Legal Business Name): JOSEPH DANIEL MEGA MD,MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 10/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE
MARTINEZ CA
94553-3156
US

IV. Provider business mailing address

3530 HARRISON ST
OAKLAND CA
94611-5423
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5200
  • Fax:
Mailing address:
  • Phone: 508-207-3957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA123127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: