Organization
GARY E. BEAN MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY ERWIN BEAN M.D. (OWNER)
(510) 530-5437
Entity
Organization
Contact information
Practice address
4180 PARK BLVD, OAKLAND, CA 94602-1207
(510) 530-5437
(510) 530-9703
Mailing address
4180 PARK BLVD, OAKLAND, CA 94602-1207
(510) 530-5437
(510) 530-9703
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G53663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G53663
LICENSE
CA
Enumeration date
04/03/2007
Last updated
08/22/2020
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