Imhotep Issaquena Medical Group, Inc.
NPI #1831261270 in San Pablo, California
Provider Information
- NPI Number
- 1831261270
- Entity Type
- Organization
- Organization Name
- Imhotep Issaquena Medical Group, Inc.
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Nov 14, 2006
- Last Updated
- Jun 27, 2008
Practice Location
- Address
- 2023 VALE RD
- Address 2
- SUITE 211
- City
- San Pablo
- State
- California
- ZIP Code
- 94806-3834
- Phone
- (510) 231-0955
Authorized Official
- Name
- OTIS EUGENE ROUNDS, MD
- Title
- PRESIDENT
- Phone
- (510) 231-0955
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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