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General NPI Number Information
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NPI Number | 1821759291
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Entity Type | Organization
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Legal Business Name | GREG HORNER MEDICAL INC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 4626 WILLOW RD
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City | PLEASANTON
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State | CA
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Zip | 94588-8517
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Country | US
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Telephone | 925-984-4734
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Fax |
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Provider Business Mailing Address
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Address Line | 5424 SUNOL BLVD STE 10-155
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City | PLEASANTON
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State | CA
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Zip | 94566-7705
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Country | US
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Telephone | 925-984-4734
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY HORNER
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Credential | MD
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Telephone | 925-984-4734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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