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General NPI Number Information
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NPI Number | 1548711138
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Entity Type | Organization
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Legal Business Name | EAST BAY WEIGHT CONTROL, INC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 39470 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-590-7727
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Fax | 925-954-4442
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Provider Business Mailing Address
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Address Line | 39470 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-590-7727
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Fax | 925-954-4442
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM HERBERT BROWN III
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Credential | MD
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Telephone | 650-703-9694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | G46351
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License Number State | CA
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