Organization
NORCAL UROLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL F DEVIVO (ADMINISTRATOR)
(510) 465-5800
Entity
Organization
Contact information
Practice address
501 S SHORE CTR W, SUITE 103, ALAMEDA, CA 94501-5762
(510) 523-0273
(510) 523-3233
Mailing address
3300 WEBSTER ST, SUITE 710, OAKLAND, CA 94609-3117
(510) 465-5800
(510) 839-8984
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0071771
—
CA
Enumeration date
10/03/2007
Last updated
05/07/2008
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