Organization
MADISON HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUNTU R DAVIS M.D. (MEDICAL DIRECTOR)
(510) 267-8010
Entity
Organization
Contact information
Practice address
400 CAPISTRANO DR, OAKLAND, CA 94603-3520
(510) 636-4210
Mailing address
1000 BROADWAY, SUITE 500, OAKLAND, CA 94607-4099
(510) 267-8000
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
12/22/2011
Last updated
05/11/2012
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