Organization
EAST BAY ENT FAC PLAS SG MD GRP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN LARMORE M.D. (OWNER)
(925) 277-9000
Entity
Organization
Contact information
Practice address
5401 NORRIS CANYON RD, SUITE 302, SAN RAMON, CA 94583-5409
(925) 277-9000
Mailing address
5401 NORRIS CANYON RD, SUITE 302, SAN RAMON, CA 94583-5409
(925) 277-9000
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
C031854
CA
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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