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EAST BAY VASCULAR MEDICAL GROUP NPI 1861503351


NPI Information

NPI: 1861503351
Provider Name: EAST BAY VASCULAR MEDICAL GROUP
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
365 HAWTHORNE AVE
SUITE 103
OAKLAND, CA
ZIP 94609
Phone: (510) 832-6131
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EAST BAY VASCULAR MEDICAL GROUP is a vascular surgery surgery in Oakland, CA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. EAST BAY VASCULAR MEDICAL GROUP NPI is 1861503351. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

365 HAWTHORNE AVE
SUITE 103
OAKLAND, CA
ZIP 94609-107
Phone: (510) 832-6131

The provider's authorized official is Nanci Carter Webb .
The authorized official title is Practice Manager and has the following contact phone number (510) 832-6131.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 1/30/2008.


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
12086S0129XSurgeryVascular SurgeryYes

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
1ZZZ82873ZMEDICAIDCALIFORNIA
2CP6153MEDICARE PINCALIFORNIA
3ZZZ82873ZMEDICARE PINCALIFORNIA

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

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