Ingersoll, Otis Perry Max

Ingersoll, Otis Perry Max is an individual health care provider with primary practice located at 500 San Pablo Ave , Albany CA 94706-1103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Ingersoll, Otis Perry Max can be contacted via phone (510) 204-8130.

Contact Information

Primary practice address
500 San Pablo Ave Albany CA 94706-1103
Phone: (510) 204-8130
Fax: (510) 524-0861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 14774 California

Profile Details

NPI number 1386838407
LBN Legal business name Ingersoll, Otis Perry Max
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2007
Last updated Feb 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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