Provider Demographics
NPI:1497050397
Name:PEDIATRIC CONTRACTING SERVICES, INC.
Entity Type:Organization
Organization Name:PEDIATRIC CONTRACTING SERVICES, INC.
Other - Org Name:PEDIATRIC CONTRACTING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR - BUSINESS & EI SVS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRENFELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-610-5234
Mailing Address - Street 1:150 GRAND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 GRAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3781
Practice Address - Country:US
Practice Address - Phone:510-451-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine