Provider Demographics
NPI:1558323394
Name:MICHAEL T. TEMKIN DO, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL T. TEMKIN DO, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:TEMKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:925-866-3900
Mailing Address - Street 1:1081 MARKET PL
Mailing Address - Street 2:#300
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4773
Mailing Address - Country:US
Mailing Address - Phone:925-866-3900
Mailing Address - Fax:925-866-3901
Practice Address - Street 1:1081 MARKET PL
Practice Address - Street 2:#300
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4773
Practice Address - Country:US
Practice Address - Phone:925-866-3900
Practice Address - Fax:925-866-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6924207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA020A69240Medicare ID - Type Unspecified
CAH08067Medicare UPIN