Joanne Amala Supersad
MD | Pediatric Adolescent Medicine | Female
Joanne Amala Supersad, MD is a Martinez, California based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Joanne Amala Supersad is
200 Muir Rd, Martinez, California - 94553-4614. She can be contacted on phone at
925-372-1000.
Joanne Amala Supersad is a sole proprietor of her business.
NPI number (Unique professional ID) for Joanne Amala Supersad is
1013096148 which was assigned by NPPES on 02 Nov, 2006 and it was last updated on 08 Jul, 2007.
Joanne Amala Supersad license number is
G51939 for Pediatrics Adolescent Medicine (2080A0000X) in California.
Joanne Amala Supersad specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Joanne Amala Supersad basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Joanne Amala Supersad |
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| Credential : | MD |
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| Gender : | Female |
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Business Address:
Joanne Amala Supersad address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 200 Muir Rd
Martinez, CA, 94553-4614
United States |
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| Phone Number : | 925-372-1000 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1013096148 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 02 Nov, 2006 |
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| Last Updated On : | 08 Jul, 2007 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Joanne Amala Supersad are as mentioned. Primary taxonomy code for Joanne Amala Supersad, MD is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | G51939 | CA |
Legacy Identifiers:
Other legacy medical identifiers of Joanne Amala Supersad such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 00G519390 | MEDICAID | CA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1800 Harrison St Fl 7
Oakland, CA, 94612-3429
United States |
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| Phone Number : | 510-625-6262 |
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Business Location:
Patients can refer following map for directions to
Joanne Amala Supersad practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.