Organization
I 5 MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN SANTEE (OFFICE MGR)
(510) 547-5633
Entity
Organization
Contact information
Practice address
5915 B HOLLIS STREET, EMERYVILLE, CA 94608
(510) 547-5633
Mailing address
5915 B HOLLIS STREET, EMERYVILLE, CA 94608
(510) 547-5633
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
C2421957
CA
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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