Basic Information
| Provider Information | |||||||||
| NPI: | 1205967957 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAN RAMON OCCUPATIONAL MEDICINE MEDICAL GROUP,INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 188 | ||||||||
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| City: | OAKDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953610188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2098451346 | ||||||||
| FaxNumber: | 2098451365 | ||||||||
| Practice Location | |||||||||
| Address1: | 6001 NORRIS CANYON RD | ||||||||
| Address2: | |||||||||
| City: | SAN RAMON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945835400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095801573 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TOSCANO | ||||||||
| AuthorizedOfficialFirstName: | JOE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 9252758233 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.