Provider Demographics
NPI:1053986638
Name:INDUSTRIAL MEDIC PHYSICIANS GROUP INC
Entity type:Organization
Organization Name:INDUSTRIAL MEDIC PHYSICIANS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-978-4830
Mailing Address - Street 1:3700 DELTA FAIR BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-4075
Mailing Address - Country:US
Mailing Address - Phone:925-978-4830
Mailing Address - Fax:
Practice Address - Street 1:3700 DELTA FAIR BLVD STE B
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4075
Practice Address - Country:US
Practice Address - Phone:925-978-4830
Practice Address - Fax:925-775-4801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDUSTRIAL MEDIC CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No291U00000XLaboratoriesClinical Medical Laboratory