EDEN EMERGENCY MEDICAL GROUP INC
Osteopathic Medicine at Lake Chabot Rd, Hayward, CA

License number
California 001645
Category
Osteopathic Medicine
Type
Emergency Medicine
Owner
Name: MERRILL A CHANDLER MD
Title: AUTHORIZED OFFICIAL
Phone: (209) 342-2300
Address
Address 2
20103 Lake Chabot Rd DEPT EMERGENCY, Hayward, CA 94546
4301 Northstar Way, Modesto, CA 95356
National Provider ID: 1891786240
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EDEN EMERGENCY MEDICAL GROUP, INC

Oakland, CA  -  Hayward, CA

Registration:
Dec 4, 1987
Addresses:
18 Mall Ct, Oakland, CA 94611 (Physical)
20103 Lk Chabot Rd, Hayward, CA 94546
State ID:
C1500095
Business type:
Articles of Incorporation
Presidents:
Sushma Shah (President),Merrill Chandler President, inactive
Agent:
Ralph D'amato,Oakland, CA 94611 (Physical)

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