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General NPI Number Information
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NPI Number | 1811011562
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Entity Type | Organization
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Legal Business Name | SENIOR SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 2844 SUMMIT ST 212
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City | OAKLAND
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State | CA
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Zip | 94609-3637
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Country | US
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Telephone | 510-638-3134
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Fax | 510-638-3134
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Provider Business Mailing Address
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Address Line | 4100 REDWOOD RD 360
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City | OAKLAND
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State | CA
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Zip | 94619-2363
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Country | US
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Telephone | 510-638-3134
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Fax | 510-638-3134
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP G WRIGHT
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Credential | M.D.
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Telephone | 510-638-3134
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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 | G17389
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License Number State | CA
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