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Organization
EAST BAY NEPHROLOGY MEDICAL GROUP, INC
Active
Organization
EAST BAY NEPHROLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A TURNER (CHIEF OPERATING OFFICER)
(510) 841-0411
Entity
Organization
Contact information
Practice address
3043 SUMMIT ST, OAKLAND, CA 94609-3408
(510) 841-0411
(510) 845-5030
Mailing address
2905 TELEGRAPH AVE, BERKELEY, CA 94705-2063
(510) 841-0411
(510) 845-5030
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR0683
RAILROAD MEDICARE GROUP #
CA
05
—
GR0049642
—
CA
Enumeration date
10/04/2006
Last updated
10/22/2007
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