Organization
EAST BAY PEDIATRICS INC
Active
Parent organization
EAST BAY PEDIATRICS INC
Other names
East Bay Pediatric Primary Care Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST BAY PEDIATRICS INC
Authorized official
DR. ELMER JUMIG MD (PRESIDENT)
(925) 462-7700
Entity
Organization
Contact information
Practice address
2324 SANTA RITA RD, SUITE 12, PLEASANTON, CA 94566-4152
(925) 462-7700
(925) 462-7700
Mailing address
2324 SANTA RITA RD, SUITE 12, PLEASANTON, CA 94566-4152
(925) 462-7700
(925) 462-7712
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A77244
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A772440
—
CA
01
—
06311574
CIGNA PROVIDER #
CA
01
—
2667817
UNITED PROVIDER #
CA
01
—
7473685
AETNA PROVIDER #
CA
01
—
95999
PACIFICARE ID #
CA
Enumeration date
09/04/2006
Last updated
06/27/2008
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