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General NPI Number Information
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NPI Number | 1568642718
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Entity Type | Organization
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Legal Business Name | THE TERRACE STREET MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 1081 MARKET PL SUITE 500
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City | SAN RAMON
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State | CA
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Zip | 94583-4749
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Country | US
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Telephone | 925-452-6644
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Fax | 925-452-6685
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Provider Business Mailing Address
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Address Line | 1081 MARKET PL SUITE 500
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City | SAN RAMON
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State | CA
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Zip | 94583-4749
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Country | US
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Telephone | 925-452-6644
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Fax | 925-452-6685
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Authorized Official
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Title or Position | M.D.
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Name | DR. HELEN E MATTHEWS
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Credential | M.D.
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Telephone | 925-452-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A83428
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License Number State | CA
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