MEDICARE: E P MAGALONG JR MD INC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1124787171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E P MAGALONG JR MD INC

Provider Business Mailing Address
First Line	:	1050 MARINA VILLAGE PKWY STE 101
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1033
Country	:	US
Telephone Number	:	510-227-5540
Fax Number	:	510-788-6849

Provider Business Practice Location Address
First Line	:	1050 MARINA VILLAGE PKWY STE 101
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1033
Country	:	US
Telephone Number	:	510-227-5540
Fax Number	:	510-788-6849

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELPIDIO POSA MAGALONG JR.
Credential	:	MD
Telephone Number	:	510-227-5540

Provider Enumeration Date	:	12/16/2021
Last Update Date	:	11/15/2024

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