Provider Demographics
NPI:1134145055
Name:INFECTIOUS DISEASE DOCTORS MEDICAL GROUP APC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE DOCTORS MEDICAL GROUP APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-947-2334
Mailing Address - Street 1:365 LENNON LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5910
Mailing Address - Country:US
Mailing Address - Phone:925-947-2334
Mailing Address - Fax:925-947-5889
Practice Address - Street 1:365 LENNON LN
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-5910
Practice Address - Country:US
Practice Address - Phone:925-947-2334
Practice Address - Fax:925-947-5889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0077920Medicaid
1134145055Medicare PIN