Provider Demographics
NPI:1477696458
Name:WARBRITTON, JOHN D III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:WARBRITTON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 ALICE LN
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-3601
Mailing Address - Country:US
Mailing Address - Phone:510-839-5564
Mailing Address - Fax:510-839-1692
Practice Address - Street 1:300 FRANK H OGAWA PLZ STE 700
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2048
Practice Address - Country:US
Practice Address - Phone:510-350-4000
Practice Address - Fax:510-839-1692
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG47015174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943354148OtherTAX IDENTIFICATION NUMBER
CA00G470150Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CAA50569Medicare UPIN