# MYOFASCIAL RESTORATION AND INTEGRATION POMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Myofascial Restoration and Integration
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356916290
- **Authorized official:** EDWARD T VERCELES DO (OWNER, AUTHORIZED OFFICIAL)
- **Authorized official phone:** (925) 326-8471

## Contact information

- **Practice address:** 411 30TH ST STE 314, OAKLAND, CA 94609-3312
- **Practice address phone:** (925) 326-8471
- **Mailing address:** 155 SAINT GERMAIN LN, PLEASANT HILL, CA 94523-1135
- **Mailing address phone:** (925) 326-8471

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2021
- **Last updated:** 06/08/2021