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General NPI Number Information
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NPI Number | 1114250404
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Entity Type | Organization
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Legal Business Name | MICHAEL E. GORIN, MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 501 S SHORE CTR W SUITE 103B
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City | ALAMEDA
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State | CA
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Zip | 94501-5762
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Country | US
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Telephone | 510-521-6510
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Fax | 510-521-1465
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Provider Business Mailing Address
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Address Line | 501 S SHORE CTR W SUITE 103B
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City | ALAMEDA
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State | CA
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Zip | 94501-5762
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Country | US
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Telephone | 510-521-6510
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Fax | 510-521-1465
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL EDWARD GORIN
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Credential | M.D.
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Telephone | 510-521-6510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G34231
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License Number State | CA
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