Provider Demographics
NPI:1295076933
Name:MUIR FAMILY PHYSICIANS MEDICAL GROUP INC.
Entity type:Organization
Organization Name:MUIR FAMILY PHYSICIANS MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-513-9495
Mailing Address - Street 1:3291 WALNUT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4412
Mailing Address - Country:US
Mailing Address - Phone:925-513-9495
Mailing Address - Fax:925-626-3782
Practice Address - Street 1:3291 WALNUT BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-4412
Practice Address - Country:US
Practice Address - Phone:925-513-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty