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General NPI Number Information
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NPI Number | 1386770931
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Entity Type | Organization
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Legal Business Name | CONTRA COSTA MEDICAL SERVICES
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 595 CENTER AVE STE 100
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City | MARTINEZ
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State | CA
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Zip | 94553-4629
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Country | US
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Telephone | 925-313-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 595 CENTER AVE STE 100
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City | MARTINEZ
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State | CA
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Zip | 94553-4629
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GOVERNMENT RELATIONS DIRECTOR
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Name | MR. FRANK LEE
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Credential | J.D.
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Telephone | 925-313-6082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 9330054
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License Number State | CA
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