Provider Demographics
NPI:1275753493
Name:JOHN MUIR HEALTH
Entity Type:Organization
Organization Name:JOHN MUIR HEALTH
Other - Org Name:JOHN MUIR MEDICAL CENTER WALNUT CREEK NON INVASI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-941-2279
Mailing Address - Street 1:1601 YGNACIO VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3122
Mailing Address - Country:US
Mailing Address - Phone:925-939-3000
Mailing Address - Fax:925-941-2236
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:925-939-3000
Practice Address - Fax:925-941-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZA0703ZOtherBL SHIELD PROVIDER NUMBER
CA050180OtherBLUE CROSS PROV NUMBER
CAZZZA0703ZOtherBL SHIELD PROVIDER NUMBER