Provider Type Icon

EAST BAY FAMILY PRACTICE MEDICAL GROUP INC NPI 1154313237


NPI Information

NPI: 1154313237
Provider Name: EAST BAY FAMILY PRACTICE MEDICAL GROUP INC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
3100 TELEGRAPH AVE
STE 2109
OAKLAND, CA
ZIP 94609
Phone: (510) 645-9900
Get Directions

EAST BAY FAMILY PRACTICE MEDICAL GROUP INC is a family medicine in Oakland, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EAST BAY FAMILY PRACTICE MEDICAL GROUP INC NPI is 1154313237. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3100 TELEGRAPH AVE
STE 2109
OAKLAND, CA
ZIP 94609-210
Phone: (510) 645-9900
Fax: (510) 645-9919

The provider's authorized official is Audrey D'andrea .
The authorized official title is Vice President Share Holder and has the following contact phone number (510) 645-9900.

The enumeration date for this NPI number is 8/16/2005 and was last updated on 8/22/2020.


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 MedicineYes

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
1GR0003490MEDICAIDCALIFORNIA

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: 11/14/2023

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.