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PINE PARK HEALTH INC NPI 1346879848


NPI Information

NPI: 1346879848
Provider Name: PINE PARK HEALTH, INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 03D2269060

Address:
1144 65TH ST STE F
OAKLAND, CA
ZIP 94608
Phone: (510) 929-1400
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PINE PARK HEALTH, INC is an internal medicine in Oakland, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PINE PARK HEALTH, INC NPI is 1346879848. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1144 65TH ST STE F
OAKLAND, CA
ZIP 94608-053
Phone: (510) 929-1400
Fax: (510) 929-1414

The provider's authorized official is Stephanie Vanzee .
The authorized official title is Credentialing Coordinator and has the following contact phone number (469) 401-8820.

The CLIA number assigned to this NPI record is 03D2269060 - other - testing in alf with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2020 and was last updated on 9/7/2023.


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
1207Q00000XFamily MedicineNo
2207QA0505XFamily MedicineAdult MedicineNo
3363LP2300XNurse PractitionerPrimary CareNo
4363LA2200XNurse PractitionerAdult HealthNo
5363LF0000XNurse PractitionerFamilyNo
6363LG0600XNurse PractitionerGerontologyNo
7207QG0300XFamily MedicineGeriatric MedicineNo
8363A00000XPhysician AssistantNo
9363L00000XNurse PractitionerNo
10363LA2100XNurse PractitionerAcute CareNo
11207R00000XInternal MedicineYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.