Provider Demographics
NPI:1508866740
Name:LOUIE, JOHN G (MD)
Entity Type:Individual
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First Name:JOHN
Middle Name:G
Last Name:LOUIE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5575 W LAS POSITAS BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5801
Mailing Address - Country:US
Mailing Address - Phone:925-463-0590
Mailing Address - Fax:925-847-9532
Practice Address - Street 1:5575 W LAS POSITAS BLVD
Practice Address - Street 2:STE 130
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5801
Practice Address - Country:US
Practice Address - Phone:925-463-0590
Practice Address - Fax:925-847-9532
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2015-11-20
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Provider Licenses
StateLicense IDTaxonomies
CAG48591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G485910Medicaid
A92833Medicare UPIN
A92833Medicare UPIN