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General NPI Number Information
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NPI Number | 1659187599
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Entity Type | Organization
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Legal Business Name | NORCAL UROLOGY
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 3300 WEBSTER ST STE 710
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City | OAKLAND
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State | CA
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Zip | 94609-3122
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Country | US
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Telephone | 510-465-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 WEBSTER ST STE 710
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City | OAKLAND
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State | CA
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Zip | 94609-3122
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Country | US
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Telephone | 510-465-5800
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Fax |
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Authorized Official
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Title or Position | MD
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Name | CHARLES WEN RAMON REGIONAL MEDIC WEN
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Credential | MD
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Telephone | 510-500-7116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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