Organization
AVANT INPATIENT SERVICES MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL J JESSOP MD (PRESIDENT)
(510) 889-5082
Entity
Organization
Contact information
Practice address
20103 LAKE CHABOT RD, CASTRO VALLEY, CA 94546-5341
(510) 889-5082
(510) 733-0878
Mailing address
PO BOX 26529, SANTA ANA, CA 92799-6529
(714) 689-1500
(714) 918-0135
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G44754
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0087602
—
CA
Enumeration date
04/27/2006
Last updated
08/22/2020
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