Healthcare Provider Details

I. General information

NPI: 1114529757
Provider Name (Legal Business Name): AMG MEDICAL GROUP (DE), P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 HOPYARD RD STE 100
PLEASANTON CA
94588-7101
US

IV. Provider business mailing address

7600 CHEVY CHASE DR STE 300
AUSTIN TX
78752-1599
US

V. Phone/Fax

Practice location:
  • Phone: 561-901-1741
  • Fax:
Mailing address:
  • Phone: 844-362-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN WILLIAMS
Title or Position: PRESIDENT
Credential: MD
Phone: 844-362-2559