Provider Demographics
NPI:1679884829
Name:MACARTHUR GASTROENTEROLOGY INC.
Entity Type:Organization
Organization Name:MACARTHUR GASTROENTEROLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:DARNICE
Authorized Official - Last Name:WILLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-562-7467
Mailing Address - Street 1:PO BOX 5518
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-0518
Mailing Address - Country:US
Mailing Address - Phone:510-562-7467
Mailing Address - Fax:510-635-9025
Practice Address - Street 1:10520 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5248
Practice Address - Country:US
Practice Address - Phone:510-562-7467
Practice Address - Fax:510-635-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G490990261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy