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Organization
EAST BAY PULMONARY MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization
EAST BAY PULMONARY MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COLLEEN TEJANO (OFFICE MANAGER)
(510) 329-5421
Entity
Organization
Contact information
Practice address
2000 VALE RD, SAN PABLO, CA 94806-3808
(510) 222-5421
(510) 222-5249
Mailing address
2000 VALE RD, SAN PABLO, CA 94806-3808
(510) 222-5421
(510) 222-5249
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
0000001075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0001530
—
CA
Enumeration date
07/22/2006
Last updated
07/31/2014
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