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Organization
FAMILY PRACTICE MEDICAL GROUP OF OAKLAND
Active
Organization
FAMILY PRACTICE MEDICAL GROUP OF OAKLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAREEN RENEE WHITLEY MD (PRESIDENT)
(510) 419-0230
Entity
Organization
Contact information
Practice address
350 30TH ST, SUITE 407, OAKLAND, CA 94609-3425
(510) 419-0230
(510) 419-0440
Mailing address
350 30TH ST, SUITE 407, OAKLAND, CA 94609-3425
(510) 419-0230
(510) 419-0440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ45714Z
BLUE SHIELD
CA
Enumeration date
04/14/2006
Last updated
05/26/2011
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