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BERKELEY UROLOGICAL ASSOCIATES A MEDICAL GROUP INC. FKA LYON NPI 1992872410


NPI Information

NPI: 1992872410
Provider Name: BERKELEY UROLOGICAL ASSOCIATES A MEDICAL GROUP INC. FKA LYON
Classification: Urology - 2088P0231X
Entity Type: Organization

Specialization: Pediatric Urology

Address:
2999 REGENT ST
#612
BERKELEY, CA
ZIP 94705
Phone: (510) 848-1733
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BERKELEY UROLOGICAL ASSOCIATES A MEDICAL GROUP INC. FKA LYON is a pediatric urology urology in Berkeley, CA. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). BERKELEY UROLOGICAL ASSOCIATES A MEDICAL GROUP INC. FKA LYON NPI is 1992872410. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2999 REGENT ST
#612
BERKELEY, CA
ZIP 94705-146
Phone: (510) 848-1733
Fax: (510) 848-8224

The provider's authorized official is Tina M Bettencourt .
The authorized official title is Practice Administrator and has the following contact phone number (510) 848-1733.

The enumeration date for this NPI number is 11/29/2006 and was last updated on 3/12/2009.


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
12088P0231XUrologyPediatric UrologyYes

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
1ZZZ17211ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2YYY49005YMEDICAIDCALIFORNIA

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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