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Organization
FULL CARE MEDICAL GROUP, INC.
Active
Organization
FULL CARE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI A KHONSARI (CFO BUSINESS MANAGER)
(925) 755-1255
Entity
Organization
Contact information
Practice address
3903 LONE TREE WAY, SUITE 104, ANTIOCH, CA 94509-6249
(925) 755-1255
(925) 755-1259
Mailing address
3903 LONE TREE WAY, SUITE 104, ANTIOCH, CA 94509-6249
(925) 755-1255
(925) 755-1259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48607
CA
Other
Enumeration date
07/08/2006
Last updated
12/19/2012
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