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Organization

NEUROLOGY MED ASSOCS CHO

Active
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Organization

NEUROLOGY MED ASSOCS CHO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL BIRNBAUM MD (HEAD OF DEPT)
(510) 428-3590
Entity
Organization

Contact information

Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3590
(510) 601-3974
Mailing address
3116 W MARCH LN, STE 200, STOCKTON, CA 95219-2369
(209) 473-6555
(209) 473-6543

Taxonomy

Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
G49267
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G49267
DR BIRNBAUM'S CA MD LIC
CA
01
GR0094870
MEDI-CAL
CA
Enumeration date
02/23/2007
Last updated
08/22/2020
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