Healthcare Provider Details

I. General information

NPI: 1457781247
Provider Name (Legal Business Name): NAPA MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 LENNON LN SUITE 250
WALNUT CREEK CA
94598-5910
US

IV. Provider business mailing address

365 LENNON LN SUITE 250
WALNUT CREEK CA
94598-5910
US

V. Phone/Fax

Practice location:
  • Phone: 925-932-6330
  • Fax: 925-357-3764
Mailing address:
  • Phone: 925-932-6330
  • Fax: 925-932-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: AILEEN NIU
Title or Position: CREDENTIALS COORDINATOR
Credential:
Phone: 925-350-4059