Provider Demographics
NPI:1760627509
Name:NORTHERN CALIFORNIA ORTHOPAEDIC MEDICAL GRP, INC
Entity Type:Organization
Organization Name:NORTHERN CALIFORNIA ORTHOPAEDIC MEDICAL GRP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZACHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-991-9400
Mailing Address - Street 1:901 CAMPUS DRIVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4930
Mailing Address - Country:US
Mailing Address - Phone:650-991-9400
Mailing Address - Fax:650-991-2650
Practice Address - Street 1:901 CAMPUS DRIVE
Practice Address - Street 2:SUITE 111
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4930
Practice Address - Country:US
Practice Address - Phone:650-991-9400
Practice Address - Fax:650-991-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty