# NEPHROLOGY MED ASSOCS CHO

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

## Provider details

- **NPI number:** 1639205917
- **Authorized official:** ROSE ELLEN MORRELL MD (HEAD OF DEPT)
- **Authorized official phone:** (510) 428-3335

## Contact information

- **Practice address:** 747 52ND ST, OAKLAND, CA 94609-1809
- **Practice address phone:** (510) 428-3335
- **Practice address fax:** (510) 450-5850
- **Mailing address:** 3116 W MARCH LN, STE 200, STOCKTON, CA 95219-2369
- **Mailing address phone:** (209) 473-6555
- **Mailing address fax:** (209) 473-6543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | G31927 | CA | Yes |

## Other

- **Enumeration date:** 02/23/2007
- **Last updated:** 08/22/2020