Provider Demographics
NPI:1306063375
Name:MUIR DIABLO OCCUPATIONAL MEDICINE MEDICAL GROUP INC.
Entity type:Organization
Organization Name:MUIR DIABLO OCCUPATIONAL MEDICINE MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PIERCE
Authorized Official - Last Name:GUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-685-1212
Mailing Address - Street 1:2231 GALAXY CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4933
Mailing Address - Country:US
Mailing Address - Phone:925-685-7744
Mailing Address - Fax:925-685-0462
Practice Address - Street 1:2231 GALAXY CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4933
Practice Address - Country:US
Practice Address - Phone:925-685-7744
Practice Address - Fax:925-685-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine