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NPI Code Detail

MEDICARE: GREGORY A. MINEVICH M.D. PROFESSIONAL CORP

MEDICARE: GREGORY A. MINEVICH M.D. PROFESSIONAL CORP
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
1207V00000XObstetrics & Gynecology PhysicianA93150CA

General Provider Information

NPI Number : 1538482286
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREGORY A. MINEVICH M.D. PROFESSIONAL CORP
Provider Business Mailing Address
First Line : 1290 B ST STE 305
Second Line :
City : HAYWARD
State : CA
Zip : 94541-2967
Country : US
Telephone Number : 510-582-8281
Fax Number : 510-582-4557
Provider Business Practice Location Address
First Line : 1290 B ST STE 305
Second Line :
City : HAYWARD
State : CA
Zip : 94541-2967
Country : US
Telephone Number : 510-582-8281
Fax Number : 510-582-4557
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. MONIKA L KING
Credential :
Telephone Number : 510-582-8281
Provider Enumeration Date : 03/09/2010
Last Update Date : 01/28/2011

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