Provider Demographics
NPI:1972558575
Name:MCBRIDE, PAMELA J (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2111 WHITEHALL PL
Mailing Address - Street 2:STE B
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501
Mailing Address - Country:US
Mailing Address - Phone:510-521-2027
Mailing Address - Fax:510-521-2029
Practice Address - Street 1:2111 WHITEHALL PL
Practice Address - Street 2:STE B
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501
Practice Address - Country:US
Practice Address - Phone:510-521-2027
Practice Address - Fax:510-521-2029
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG85601208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G856010Medicaid
F87907Medicare UPIN
CA00G856010Medicaid