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BANCROFT PEDIATRIC MEDICAL GROUP NPI 1316903461


NPI Information

NPI: 1316903461
Provider Name: BANCROFT PEDIATRIC MEDICAL GROUP

Doing Business As: BANCROFT PEDIATRIC MEDICAL GROUP

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1555 DOOLITTLE DR. 180
SAN LEANDRO, CA
ZIP 94577
Phone: (510) 483-2600
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BANCROFT PEDIATRIC MEDICAL GROUP is a pediatrics in San Leandro, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BANCROFT PEDIATRIC MEDICAL GROUP NPI is 1316903461. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bancroft Pediatric Medical Group.

The provider's business location address is:

1555 DOOLITTLE DR. 180
SAN LEANDRO, CA
ZIP 94577
Phone: (510) 483-2600
Fax: (510) 483-2605

The provider's authorized official is Mirian Rhew .
The authorized official title is Senior Partner and has the following contact phone number (510) 483-2600.

The enumeration date for this NPI number is 4/25/2006 and was last updated on 1/6/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A60244OTHERLAURA DENENBERG MD LICENS
2I15988MEDICARE UPIN
320A10768OTHERCALIFORNIAMICHELE TAMSE
4A102586OTHERCALIFORNIADARCY GRANT LICENSE
5F15367MEDICARE UPIN
6A128385OTHERCALIFORNIAJUDITH MILLSTEIN LICENSE
7A40292OTHERMARIA E BEAMER MD LICENSE
8A63180OTHERSTEVE SANTUCCI MD LICENSE
9G08630MEDICARE UPIN
10A69220OTHERCALIFORNIAREI MASUI LICENSE
11G88666MEDICARE UPIN
12G80985OTHERLAURA GRUNBAUM MD LICENSE
13A63066OTHERMIRIAM M RHEW MD LICENSE
14I15989MEDICARE UPIN
15I46484MEDICARE UPIN
16A86342MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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