Provider Demographics
NPI:1265262828
Name:CONTRA COSTA COUNTY
Entity type:Organization
Organization Name:CONTRA COSTA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:DECESARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-957-5429
Mailing Address - Street 1:50 DOUGLAS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4098
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:
Practice Address - Street 1:25 ALLEN ST
Practice Address - Street 2:SUITE B
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553
Practice Address - Country:US
Practice Address - Phone:844-844-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTRA COSTA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-07
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care