Organization
EAST BAY AIDS CENTER MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY BURACK (PRESIDENT)
(510) 869-8480
Entity
Organization
Contact information
Practice address
3100 SUMMIT ST, 2ND FLOOR, OAKLAND, CA 94609-3410
(510) 869-8400
(510) 869-8475
Mailing address
3100 SUMMIT ST, 2ND FLOOR, OAKLAND, CA 94609
(510) 869-8488
(510) 869-8478
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
CA
207RI0200X
Infectious Disease Physician
Primary
—
CA
363LF0000X
Family Nurse Practitioner
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0087700
—
CA
Enumeration date
06/24/2006
Last updated
12/22/2022
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