Provider Demographics
NPI:1699011072
Name:BIZMED OCCUPATIONAL HEALTH CLINIC
Entity Type:Organization
Organization Name:BIZMED OCCUPATIONAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:510-226-8832
Mailing Address - Street 1:42650 CHRISTY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-3135
Mailing Address - Country:US
Mailing Address - Phone:510-226-8832
Mailing Address - Fax:510-226-8958
Practice Address - Street 1:42650 CHRISTY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-3135
Practice Address - Country:US
Practice Address - Phone:510-226-8832
Practice Address - Fax:510-226-8958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A52362083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty