PINE PARK HEALTH INC NPI 1346879848

NPI Information

PINE PARK HEALTH, INC is a family medicine in Oakland, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PINE PARK HEALTH, INC NPI is 1346879848. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1144 65TH ST STE F
OAKLAND, CA
ZIP 94608-053
Phone: (510) 929-1400
Fax: (510) 929-1414

The provider's authorized official is Kendell Cannon .
The authorized official title is Chief Medical Officer and has the following contact phone number (510) 929-1400.

The CLIA number assigned to this NPI record is 05D2191945 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2020 and was last updated on 11/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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