Healthcare Provider Details

I. General information

NPI: 1497050397
Provider Name (Legal Business Name): PEDIATRIC CONTRACTING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GRAND AVE SUITE 101
OAKLAND CA
94612-3781
US

IV. Provider business mailing address

150 GRAND AVE SUITE 101
OAKLAND CA
94612-3781
US

V. Phone/Fax

Practice location:
  • Phone: 510-451-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE GRENFELL
Title or Position: DIRECTOR - BUSINESS & EI SVS
Credential:
Phone: 510-610-5234