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NPI Code Detail

MEDICARE: AMERICAN HEALTH MEDICAL GROUP

MEDICARE: AMERICAN HEALTH MEDICAL GROUP
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
1174400000XSpecialistG55824CA

General Provider Information

NPI Number : 1528472636
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN HEALTH MEDICAL GROUP
Provider Business Mailing Address
First Line : 1900 OFARRELL ST
Second Line : SUITE 100
City : SAN MATEO
State : CA
Zip : 94403-1386
Country : US
Telephone Number : 650-645-1100
Fax Number : 650-645-1197
Provider Business Practice Location Address
First Line : 1900 OFARRELL ST
Second Line : SUITE 100
City : SAN MATEO
State : CA
Zip : 94403-1386
Country : US
Telephone Number : 650-645-1100
Fax Number : 650-645-1197
Authorized Official
Title or Position : PRESIDENT
Name : MR. WILLIAM GEORGE BROSE
Credential : MD
Telephone Number : 650-645-1100
Provider Enumeration Date : 06/17/2014
Last Update Date : 06/17/2014

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Directions to “AMERICAN HEALTH MEDICAL GROUP ” Practice Location

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