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NPI Code Detail

MEDICARE: JONATHAN C ALBEG MD

MEDICARE: JONATHAN C ALBEG MD
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
1207R00000XInternal Medicine PhysicianA64791CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A64791OTHERCASTATE MARCH LICENSE

General Provider Information

NPI Number : 1770677957
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN C ALBEG MD
Provider Business Mailing Address
First Line : 2350 W. EL CAMINO REAL
Second Line : 2ND FLOOR
City : MOUNTAIN VIEW
State : CA
Zip : 94040-6203
Country : US
Telephone Number : 707-433-7258
Fax Number : 707-433-8807
Provider Business Practice Location Address
First Line : 717 CENTER ST
Second Line :
City : HEALDSBURG
State : CA
Zip : 95448-3604
Country : US
Telephone Number : 707-433-7258
Fax Number : 707-433-8807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 03/07/2023

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