Basic Information
| Provider Information | |||||||||
| NPI: | 1437119591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22210 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946232210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105354000 | ||||||||
| FaxNumber: | 5105354189 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 FRUITVALE AVENUE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946012322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105356300 | ||||||||
| FaxNumber: | 5105354019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2006 | ||||||||
| LastUpdateDate: | 09/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 46482 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 46482 | MN | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | A99461 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 390401600 | 05 | MN | MEDICAID | NA9021043069 | 01 | MN | PREFERRED ONE | OTHER | 04-07372 | 01 | MN | MEDICA | OTHER | 971S7MU | 01 | MN | BCBS | OTHER | 132659 | 01 | MN | UCARE | OTHER | HP50100 | 01 | MN | HEALTH PARTNERS | OTHER |