Provider Demographics
NPI:1003007188
Name:WHITE OAK MEDICAL OFFICE INC
Entity Type:Organization
Organization Name:WHITE OAK MEDICAL OFFICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-370-6147
Mailing Address - Street 1:51 E. CAMPBELL AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008
Mailing Address - Country:US
Mailing Address - Phone:408-370-6147
Mailing Address - Fax:408-370-6196
Practice Address - Street 1:51 E. CAMPBELL AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:408-370-6147
Practice Address - Fax:408-370-6196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0725952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty