Organization
MEDICAL GROUP AT CITY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED BLACKWELL M.D. (PRESIDENT)
(510) 748-0940
Entity
Organization
Contact information
Practice address
2100 OTIS DR, ALAMEDA, CA 94501-5786
(510) 748-0940
Mailing address
1600 SHERMAN ST, ALAMEDA, CA 94501-2236
(510) 748-0940
(510) 748-0926
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
G15873
CA
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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