Organization
EAST BAY CARDIAC SURGERY CENTER MEDICAL GROUP
Active
Other names
Iverson & Stanten Cardiac & Thoracic Surgery Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUNAID HAMEED KHAN M.D. (MANAGING PARTNER)
(510) 465-6600
Entity
Organization
Contact information
Practice address
3300 WEBSTER ST, SUITE 500, OAKLAND, CA 94609-3117
(510) 465-6600
(510) 839-0806
Mailing address
3300 WEBSTER ST, SUITE 500, OAKLAND, CA 94609-3117
(510) 465-6600
(510) 839-0806
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0060340
—
CA
01
—
ZZZ03169Z
BLUE SHIELD GRP PROVIDER#
CA
Enumeration date
08/30/2006
Last updated
03/10/2015
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