Organization Name: | ALAMEDA SPINE AND PHYSICAL MEDICINE INC. |
NPI Number: | 1700124260 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN CHRISTIAN O'NEIL (OWNER) |
Mailing Address: | 2329a Eagle Ave Alameda |
State: | CA US |
Postal Code: | 945011408 |
Phone Number: | 5107690125 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2013 |
NPI Last Update Date: | 01/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A118663 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |