Provider Demographics
NPI:1750034427
Name:G6 CONCIERGE MEDICINE INC
Entity Type:Organization
Organization Name:G6 CONCIERGE MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JUHI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:415-500-4289
Mailing Address - Street 1:PO BOX 6671
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95406-0671
Mailing Address - Country:US
Mailing Address - Phone:415-500-4289
Mailing Address - Fax:415-325-5536
Practice Address - Street 1:897 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1916
Practice Address - Country:US
Practice Address - Phone:415-500-4289
Practice Address - Fax:415-325-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty