Healthcare Provider Details

I. General information

NPI: 1992990592
Provider Name (Legal Business Name): NORTHERN CALIFORNIA GASTROENTEROLOGY CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 WALNUT BLVD SUITE A
WALNUT CREEK CA
94596-6132
US

IV. Provider business mailing address

4450 WALNUT BLVD SUITE A
WALNUT CREEK CA
94596-6132
US

V. Phone/Fax

Practice location:
  • Phone: 925-944-4837
  • Fax: 303-678-0823
Mailing address:
  • Phone: 925-944-4837
  • Fax: 303-678-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRIS HRUBESKY
Title or Position: COO
Credential:
Phone: 925-944-4837