Provider Demographics
NPI:1053697037
Name:SPHERICAL MEDICAL, PC
Entity type:Organization
Organization Name:SPHERICAL MEDICAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMONS
Authorized Official - Middle Name:HULL
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-265-1082
Mailing Address - Street 1:2070 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4399
Mailing Address - Country:US
Mailing Address - Phone:510-265-1082
Mailing Address - Fax:510-265-1015
Practice Address - Street 1:2070 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4399
Practice Address - Country:US
Practice Address - Phone:510-814-4397
Practice Address - Fax:510-265-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-22
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty