Provider Demographics
NPI:1891740403
Name:INTERNAL MEDICINE ASSOCIATES OF SAN MATEO
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF SAN MATEO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NONI
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-373-0919
Mailing Address - Street 1:50 S SAN MATEO DR
Mailing Address - Street 2:SUITE 370
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3857
Mailing Address - Country:US
Mailing Address - Phone:650-347-0063
Mailing Address - Fax:650-579-7814
Practice Address - Street 1:50 S SAN MATEO DR
Practice Address - Street 2:SUITE 370
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3857
Practice Address - Country:US
Practice Address - Phone:650-347-0063
Practice Address - Fax:650-579-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty