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General NPI Number Information
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NPI Number | 1629393426
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Entity Type | Organization
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Legal Business Name | CONTRA COSTA REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 2500 ALHAMBRA
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City | MARTINEZ
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State | CA
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Zip | 94553
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Country | US
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Telephone | 925-646-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 N MAIN ST--PMB 73
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City | WALNUT CREEK
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State | CA
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Zip | 94596
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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 | DIRECTOR HEALTH SERVICES
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Name | DR. WILLIAM WALKER
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Credential | MD
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Telephone | 925-646-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 33230
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License Number State | CA
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