Healthcare Provider Details

I. General information

NPI: 1629393426
Provider Name (Legal Business Name): CONTRA COSTA REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA
MARTINEZ CA
94553
US

IV. Provider business mailing address

1630 N MAIN ST--PMB 73
WALNUT CREEK CA
94596
US

V. Phone/Fax

Practice location:
  • Phone: 925-646-2800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number33230
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM WALKER
Title or Position: DIRECTOR HEALTH SERVICES
Credential: MD
Phone: 925-646-2800