MEDICARE: JULIE A LONG 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
1	207X00000X	Orthopaedic Surgery Physician	015021	ME
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	015021	ME

General Provider Information

NPI Number	:	1982608733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A LONG MD

Provider Business Mailing Address
First Line	:	4626 WILLOW RD STE 200
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-8564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4626 WILLOW RD STE 200
Second Line	:
City	:	PLEASANTON
State	:	CA
Zip	:	94588-8564
Country	:	US
Telephone Number	:	925-463-0470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/26/2025

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Directions to “ JULIE A LONG MD” Practice Location

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