Healthcare Provider Details

I. General information

NPI: 1114594967
Provider Name (Legal Business Name): MENALAM HEALTH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 NORTH SYCAMORE DR.
SIMI VALLEY CA
93065-1201
US

IV. Provider business mailing address

2100 POWELL ST STE 400
EMERYVILLE CA
94608-1826
US

V. Phone/Fax

Practice location:
  • Phone: 805-955-6000
  • Fax:
Mailing address:
  • Phone: 510-350-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID ANDREW BIRDSALL
Title or Position: COO
Credential: MD
Phone: 510-851-7411