Provider Demographics
NPI:1073753042
Name:ALAMEDA MEDICAL PROFESSIONALS. INC.
Entity Type:Organization
Organization Name:ALAMEDA MEDICAL PROFESSIONALS. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-749-9817
Mailing Address - Street 1:2532 SANTA CLARA AVENUE
Mailing Address - Street 2:#171
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4634
Mailing Address - Country:US
Mailing Address - Phone:510-749-9817
Mailing Address - Fax:510-752-9094
Practice Address - Street 1:430 WILLOW STREET
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6130
Practice Address - Country:US
Practice Address - Phone:510-749-9817
Practice Address - Fax:510-752-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty