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Organization
EAST BAY SHOULDER CLINIC AND SPORTS REHABILITATION, INC
Active
Organization
EAST BAY SHOULDER CLINIC AND SPORTS REHABILITATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRK L JENSEN M.D. (PRESIDENT)
(925) 284-5300
Entity
Organization
Contact information
Practice address
3717 MT DIABLO BLVD STE 100, LAFAYETTE, CA 94549-3547
(925) 284-5300
(925) 284-5381
Mailing address
PO BOX 1298, LAFAYETTE, CA 94549-1298
(925) 284-5300
(925) 284-5381
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
03/21/2018
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