Individual
DR. FAITH J MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3012 SUMMIT ST, 2ND FLOOR, THE PERMANENTE MEDICAL GROUP, INC, OAKLAND, CA 94609-3480
(510) 869-8660
(510) 869-8661
Mailing address
3012 SUMMIT ST, 2ND FLOOR, THE PERMANENTE MEDICAL GROUP, INC, OAKLAND, CA 94609-3480
(510) 869-8660
(510) 869-8661
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
G85525
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G855250
PPIN
CA
05
—
00G855250
—
CA
Enumeration date
11/01/2006
Last updated
07/09/2007
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