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Organization
PRIMARY PEDIATRIC MEDICAL GROUP INC.
Active
Organization
PRIMARY PEDIATRIC MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY THOMPSON (PRACTICE MANAGER)
(510) 433-1040
Entity
Organization
Contact information
Practice address
3300 WEBSTER ST, SUITE 1202, OAKLAND, CA 94609-3117
(510) 433-1040
(510) 433-1043
Mailing address
PO BOX 618, NOVATO, CA 94948-0618
(510) 433-1040
(510) 433-1043
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
09/20/2006
Last updated
02/26/2009
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