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NPI Code Detail

MEDICARE: JOHN RODERICK NEALE M.D

MEDICARE: JOHN RODERICK NEALE M.D
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
1207P00000XEmergency Medicine PhysicianG21760CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689629883
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN RODERICK NEALE M.D
Provider Business Mailing Address
First Line : 2100 POWELL ST
Second Line : STE 920
City : EMERYVILLE
State : CA
Zip : 94608-1826
Country : US
Telephone Number : 510-350-2600
Fax Number : 510-879-9100
Provider Business Practice Location Address
First Line : 2500 GRANT RD
Second Line :
City : MOUNTAIN VIEW
State : CA
Zip : 94040-4302
Country : US
Telephone Number : 650-940-7055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/03/2008

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