Organization
CALIFORNIA HEART EASTBAY MEDICAL GROUP
Active
Other names
California Heart Eastbay Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELYN M KLISIEWICZ (BUSINESS MANAGER)
(925) 676-2600
Entity
Organization
Contact information
Practice address
2485 HIGH SCHOOL AVE, STE 312, CONCORD, CA 94520-1819
(925) 676-2600
(925) 680-0212
Mailing address
2485 HIGH SCHOOL AVE, STE 312, CONCORD, CA 94520-1819
(925) 676-2600
(925) 680-0212
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0050130
—
CA
Enumeration date
06/10/2005
Last updated
04/07/2008
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