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General NPI Number Information
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NPI Number | 1962852939
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE AT HOME, INC.
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 400 29TH ST SUITE 306
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City | OAKLAND
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State | CA
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Zip | 94609-3522
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Country | US
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Telephone | 510-610-0748
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Fax |
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Provider Business Mailing Address
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Address Line | 400 29TH ST SUITE 306
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City | OAKLAND
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State | CA
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Zip | 94609-3522
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Country | US
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Telephone | 510-610-0748
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Fax |
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Authorized Official
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Title or Position | CHAIR
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Name | ANTHONY E JONES
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Credential | M.D.
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Telephone | 510-610-0748
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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 | CA
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