Healthcare Provider Details
I. General information
NPI: 1275057762
Provider Name (Legal Business Name): ONE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2017
Last Update Date: 11/21/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 EMBARCADERO CENTER SUITE 1900
SAN FRANCISCO CA
94111
US
IV. Provider business mailing address
1170 BORDEAUX DRIVE, BLDG 3
SUNNYVALE CA
94089
US
V. Phone/Fax
- Phone: 888-663-6331
- Fax: 415-252-7176
- Phone: 888-201-1937
- Fax: 650-227-1107
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
ANDREW
DIAMOND
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 888-663-6331