MEDICARE: ONE MEDICAL GROUP, P.C.

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	207Q00000X	Family Medicine Physician	MD039185	DC
2	207R00000X	Internal Medicine Physician	MD039185	DC

General Provider Information

NPI Number	:	1962798645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE MEDICAL GROUP, P.C.

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:	415-520-0904

Provider Business Practice Location Address
First Line	:	1627 EYE ST NW
Second Line	:	STE. 800
City	:	WASHINGTON
State	:	DC
Zip	:	20006-4007
Country	:	US
Telephone Number	:	202-660-0015
Fax Number	:	202-660-0025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW DIAMOND
Credential	:	MD
Telephone Number	:	415-658-6791

Provider Enumeration Date	:	06/22/2011
Last Update Date	:	12/14/2020

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