Provider Demographics
NPI:1093864837
Name:JOHN MUIR TRAUMA PHYSICIANS BILLING SERVICE
Entity Type:Organization
Organization Name:JOHN MUIR TRAUMA PHYSICIANS BILLING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-941-2100
Mailing Address - Street 1:1400 TREAT BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2142
Mailing Address - Country:US
Mailing Address - Phone:925-947-5331
Mailing Address - Fax:925-941-2177
Practice Address - Street 1:1601 YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3122
Practice Address - Country:US
Practice Address - Phone:925-947-5331
Practice Address - Fax:925-941-2177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN MUIR HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-10
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0028141Medicaid
CAZZZ16041ZMedicare PIN