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General NPI Number Information
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NPI Number | 1982937090
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Entity Type | Organization
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Legal Business Name | CAMBRIDGE PUBLIC HEALTH COMMISSION/DBA/CAMBRIDGE HEALTH ALLIANCE
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 1493 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1047
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Country | US
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Telephone | 617-665-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1493 CAMBRIDGE ST
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1047
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Country | US
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Telephone | 617-665-1000
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Fax |
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Authorized Official
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Title or Position | CHAPO CAO
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Name | DAVE J PORELL
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Credential |
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Telephone | 617-499-6621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | MA
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