Imhotep Issaquena Medical Group

LBN: Imhotep Issaquena Medical Group
Imhotep Issaquena Medical Group is an health care organization with primary practice located at 401 29Th St #206, Oakland CA 94609-3519. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Imhotep Issaquena Medical Group can be contacted via phone (510) 231-0955, or through Rounds, Otis Eugene via phone (510) 231-0955.

Contact Information

Primary practice address
401 29Th St #206 Oakland CA 94609-3519
Phone: (510) 231-0955
Fax: (510) 231-0482
Website:
Map and Directions
Authorized official contact:
Name: Rounds, Otis Eugene Doctor of Medicine (MD)
Phone: (510) 231-0955

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X G33795 California

Profile Details

NPI number 1659405165
LBN Legal business name Imhotep Issaquena Medical Group
DBA Doing business as
Authorized official Rounds, Otis Eugene Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2007
Last updated Jun 27th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659405165 NPPES
California MEDICAID 00G37795

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