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General NPI Number Information
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NPI Number | 1841173663
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Entity Type | Organization
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Legal Business Name | MEDLOUNGE SAN RAMON MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 181 MARKET PL
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City | SAN RAMON
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State | CA
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Zip | 94583-4741
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Country | US
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Telephone | 801-839-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 181 MARKET PL
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City | SAN RAMON
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State | CA
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Zip | 94583-4741
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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 | OWNER
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Name | CHAD CARMAN
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Credential | DO
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Telephone | 801-839-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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