Basic Information
| Provider Information | |||||||||
| NPI: | 1811321706 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHN MUIR PHYSICIAN NETWORK | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPT 34929 | ||||||||
| Address2: | P.O. BOX 39000 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941390001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259522828 | ||||||||
| FaxNumber: | 9259522850 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 COUNTRY CLUB PLZ | ||||||||
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| City: | ORINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945632308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252549500 | ||||||||
| FaxNumber: | 9252549505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2013 | ||||||||
| LastUpdateDate: | 08/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | SORENSON | ||||||||
| AuthorizedOfficialFirstName: | M. KATHERINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT, PRACTICE MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 9259522888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.