Associated Internal Medicine Med GRP Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ASSOCIATED INTERNAL MEDICINE MED GRP INC

Practice address

350 30TH St
Ste 320
Oakland, CA 94609-3424

Phone

(510) 465-6700

Fax

(510) 465-7765

NPI assigned

Mar 31, 2006

Last updated

Jan 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dean J Nickles

Title

President

Phone

(510) 465-6700

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1215998935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "STE 320",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-465-6700",
            "fax_number": "510-465-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "STE 320",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-465-6700",
            "fax_number": "510-465-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED INTERNAL MEDICINE MED GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "NICKLES",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-465-6700"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.