Provider Demographics
NPI:1891840096
Name:ESTRIN, MARGO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGO
Middle Name:
Last Name:ESTRIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:#232
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4034
Mailing Address - Country:US
Mailing Address - Phone:925-837-6006
Mailing Address - Fax:925-837-2275
Practice Address - Street 1:901 SAN RAMON VALLEY BLVD
Practice Address - Street 2:#232
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4034
Practice Address - Country:US
Practice Address - Phone:925-837-6006
Practice Address - Fax:925-837-2275
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40199207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48133Medicare UPIN
CA00G401990Medicare ID - Type Unspecified