Individual
AUSTIN CECIL BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(301) 919-5497
(510) 535-7313
Mailing address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(301) 919-5497
(510) 535-7313
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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