Organization
BANCROFT PEDIATRIC MEDICAL GROUP
Active
Other names
Bancroft Pediatric Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAN RHEW MD (SENIOR PARTNER)
(510) 483-2600
Entity
Organization
Contact information
Practice address
1555 DOOLITTLE DR. 180, SAN LEANDRO, CA 94577
(510) 483-2600
(510) 483-2605
Mailing address
1555 DOOLITTLE DR STE 180, SAN LEANDRO, CA 94577-2239
(510) 483-2600
(510) 483-2605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A10768
MICHELE TAMSE
CA
01
—
A102586
DARCY GRANT LICENSE
CA
01
—
A128385
JUDITH MILLSTEIN LICENSE
CA
01
—
A40292
MARIA E BEAMER MD LICENSE
—
01
—
A60244
LAURA DENENBERG MD LICENS
—
01
—
A63066
MIRIAM M RHEW MD LICENSE
—
01
—
A63180
STEVE SANTUCCI MD LICENSE
—
01
—
A69220
REI MASUI LICENSE
CA
01
—
G80985
LAURA GRUNBAUM MD LICENSE
—
Enumeration date
04/25/2006
Last updated
01/06/2016
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