Provider Demographics
NPI:1962852939
Name:PRIMARY CARE AT HOME, INC.
Entity Type:Organization
Organization Name:PRIMARY CARE AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-610-0748
Mailing Address - Street 1:400 29TH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3522
Mailing Address - Country:US
Mailing Address - Phone:510-610-0748
Mailing Address - Fax:
Practice Address - Street 1:400 29TH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3522
Practice Address - Country:US
Practice Address - Phone:510-610-0748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty