Organization
DIABLO VALLEY WOMEN OB,GYN MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLEY ELLEN FILLMORE M.D. (OWNER AND PHYSICIAN)
(925) 676-3450
Entity
Organization
Contact information
Practice address
2299 BACON ST, SUITE 1, CONCORD, CA 94520-2050
(925) 676-3450
(925) 676-0615
Mailing address
2299 BACON ST, SUITE 1, CONCORD, CA 94520-2050
(925) 676-3450
(925) 676-0615
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ66213Z
BLUE SHIELD
CA
Enumeration date
02/07/2007
Last updated
01/10/2012
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