Organization
ANTIOCH MEDICAL PARK MEDICAL LAB
Active
Organization
ANTIOCH MEDICAL PARK MEDICAL LAB
Active
Parent organization
ANTIOCH MEDICAL PARK MEDICAL GROUP
Other names
ANTIOCH MEDICAL PARK LAB
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANTIOCH MEDICAL PARK MEDICAL GROUP
Authorized official
DR. J GENE ZIMMERMAN MD (DIRECTOR)
(925) 754-9223
Entity
Organization
Contact information
Practice address
3737 LONE TREE WAY, ANTIOCH, CA 94509-6065
(925) 754-1254
(925) 754-1764
Mailing address
3737 LONE TREE WAY, ANTIOCH, CA 94509-6065
(925) 754-1254
(925) 754-1764
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LAB97463F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB97463F
—
CA
Enumeration date
01/03/2008
Last updated
01/23/2008
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