Provider Demographics
NPI:1962551861
Name:JOHN MUIR TRAUMA PHYSICIANS BILLING SERVICE
Entity type:Organization
Organization Name:JOHN MUIR TRAUMA PHYSICIANS BILLING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-941-2100
Mailing Address - Street 1:1400 TREAT BLVD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-2142
Mailing Address - Country:US
Mailing Address - Phone:925-947-5331
Mailing Address - Fax:925-941-2177
Practice Address - Street 1:1601 YGNACIO VALLEY RD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3122
Practice Address - Country:US
Practice Address - Phone:925-947-5331
Practice Address - Fax:925-941-2177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0028142Medicaid
CAGR0028144Medicaid
CAGR0028148Medicaid
CAGR0028149Medicaid
CAGR002814GMedicaid
CAGR0028143Medicaid
CAGR0028145Medicaid
CAGR002814AMedicaid
CAGR002814HMedicaid
CAGR002814JMedicaid
CAGR002814KMedicaid
CAGR0028142Medicaid
CAZZZ16029ZMedicare ID - Type UnspecifiedPROVIDER GROUP NUMBER
CAZZZ16028ZMedicare ID - Type UnspecifiedPROVIDER GROUP NUMBER
CAGR0028149Medicaid
CAGR002814JMedicaid
CAZZZ16045ZMedicare ID - Type UnspecifiedPROVIDER GROUP NUMBER
CAGR002814HMedicaid
CAGR002814AMedicaid
CAGR0028143Medicaid