Healthcare Provider Details

I. General information

NPI: 1689459414
Provider Name (Legal Business Name): ENRIQUE CURIEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 INTERNATIONAL BLVD
OAKLAND CA
94601-2203
US

IV. Provider business mailing address

15337 EDGEMOOR ST
SAN LEANDRO CA
94579-2009
US

V. Phone/Fax

Practice location:
  • Phone: 510-433-8600
  • Fax:
Mailing address:
  • Phone: 510-827-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: