Healthcare Provider Details

I. General information

NPI: 1417277617
Provider Name (Legal Business Name): REDWOOD MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3128 SANTA RITA RD
PLEASANTON CA
94566-8300
US

IV. Provider business mailing address

3128 SANTA RITA RD
PLEASANTON CA
94566-8300
US

V. Phone/Fax

Practice location:
  • Phone: 925-462-9300
  • Fax: 925-426-8234
Mailing address:
  • Phone: 925-462-9300
  • Fax: 925-426-8234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG79953
License Number StateCA

VIII. Authorized Official

Name: GABY CORREA
Title or Position: OFFICE MANAGER
Credential:
Phone: 925-462-9300