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NPI Code Detail

MEDICARE: MENALAM HEALTH SERVICES PC

MEDICARE: MENALAM HEALTH SERVICES PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1003779596
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENALAM HEALTH SERVICES PC
Provider Business Mailing Address
First Line : 2100 POWELL ST STE 400
Second Line :
City : EMERYVILLE
State : CA
Zip : 94608-1872
Country : US
Telephone Number : 510-350-2600
Fax Number :
Provider Business Practice Location Address
First Line : 250 S GRAND AVE
Second Line :
City : GLENDORA
State : CA
Zip : 91741-4218
Country : US
Telephone Number : 626-963-8411
Fax Number :
Authorized Official
Title or Position : COO
Name : DAVID ANDREW BIRDSALL
Credential : MD
Telephone Number : 510-851-7411
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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