Basic Information
Provider Information
NPI: 1508007956
EntityType: 2
ReplacementNPI:  
OrganizationName: OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION
LastName:  
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Credential:  
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Mailing Information
Address1: 5080 SPECTRUM DR
Address2: SUITE 1200 WEST TOWER
City: ADDISON
State: TX
PostalCode: 750014648
CountryCode: US
TelephoneNumber: 9723648000
FaxNumber: 2147754502
Practice Location
Address1: 2 CONNECTICUT ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941072451
CountryCode: US
TelephoneNumber: 4156215055
FaxNumber: 4156210611
Other Information
ProviderEnumerationDate: 03/16/2009
LastUpdateDate: 02/17/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: WAINSTEIN
AuthorizedOfficialFirstName: JEFFREY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: SENIOR VP / CHIEF MEDICAL OFFICER
AuthorizedOfficialTelephone: 9723648000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QX0100X CAY Ambulatory Health Care FacilitiesClinic/CenterOccupational Medicine

No ID Information.


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