Organization
JOHN MUIR TRAUMA PHYSICIAN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MOODY (CHIEF FINANCIAL OFFICER)
(925) 941-2159
Entity
Organization
Contact information
Practice address
1601 YGNACIO VALLEY RD, WALNUT CREEK, CA 94598-3122
(925) 947-5331
(925) 941-2177
Mailing address
1400 TREAT BLVD, 3RD FLOOR, WALNUT CREEK, CA 94597-2142
(925) 947-5331
(925) 941-2177
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0028140
—
CA
Enumeration date
01/10/2007
Last updated
08/22/2020
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