Organization
SUMMIT ENT MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW W. MOYCE M.D. (PRESIDENT)
(510) 465-0941
Entity
Organization
Contact information
Practice address
2961 SUMMIT ST, SUITE 1, OAKLAND, CA 94609-3482
(510) 465-0941
(510) 465-0941
Mailing address
2961 SUMMIT ST, SUITE 1, OAKLAND, CA 94609-3482
(510) 465-0941
(510) 465-0941
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0067410
—
CA
01
—
ZZZ49994Z
BLUE SHIELD
CA
Enumeration date
04/04/2006
Last updated
08/23/2010
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