# INFECTIOUS DISEASE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154446425
- **Authorized official:** DR. BENEDICT VILLANUEVA M.D. (CEO)
- **Authorized official phone:** (925) 867-3829

## Contact information

- **Practice address:** 5601 NORRIS CANYON RD, SUITE 210, SAN RAMON, CA 94583-5407
- **Practice address phone:** (925) 867-3829
- **Practice address fax:** (925) 867-3820
- **Mailing address:** 5601 NORRIS CANYON RD, SUITE 210, SAN RAMON, CA 94583-5407
- **Mailing address phone:** (925) 867-3829
- **Mailing address fax:** (925) 867-3820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | A61699 | CA | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 08/22/2020