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General NPI Number Information
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NPI Number | 1972011187
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Entity Type | Organization
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Legal Business Name | STAT MED PC A CALIFORNIA MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 4465 FIRST ST
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City | LIVERMORE
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State | CA
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Zip | 94551-4915
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Country | US
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Telephone | 925-234-4447
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Fax | 925-234-4448
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Provider Business Mailing Address
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Address Line | 901 SUNVALLEY BLVD STE 100
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City | CONCORD
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State | CA
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Zip | 94520-5816
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Country | US
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Telephone | 925-234-4447
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Fax | 925-234-4448
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | MR. DANIEL FINNANE
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Credential |
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Telephone | 925-234-4447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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