GASTROENTEROLOGY ASSOCIATES OF THE EAST BAY MEDICAL GROUP INC. NPI 1407940224

NPI Information

  • NPI: 1407940224
  • Provider Name: GASTROENTEROLOGY ASSOCIATES OF THE EAST BAY MEDICAL GROUP, INC.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 05D0864483
  • Address: 2510 WEBSTER STREET
    BERKELEY, CA
    ZIP 94705
  • Phone: (510) 548-6555

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NPI Details

GASTROENTEROLOGY ASSOCIATES OF THE EAST BAY MEDICAL GROUP, INC. is a specialist in Berkeley, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GASTROENTEROLOGY ASSOCIATES OF THE EAST BAY MEDICAL GROUP, INC. NPI is 1407940224. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2510 WEBSTER STREET
BERKELEY, CA
ZIP 94705
Phone: (510) 548-6555
Fax: (510) 548-3761

The provider's authorized official is Stacey Atwood .
The authorized official title is Biller and has the following contact phone number (510) 292-4528.

The CLIA number assigned to this NPI record is 05D0864483 - practitioner other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 11/9/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ZZZ14052ZMEDICARE ID-TYPE UNSPECIFIED
2ZZZ14052ZMEDICARE UPINCALIFORNIA

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: 3/30/2025

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