Organization
EAST BAY VASCULAR MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCI CARTER WEBB (PRACTICE MANAGER)
(510) 832-6131
Entity
Organization
Contact information
Practice address
365 HAWTHORNE AVE, SUITE 103, OAKLAND, CA 94609-3107
(510) 832-6131
Mailing address
365 HAWTHORNE AVE, SUITE 103, OAKLAND, CA 94609-3107
(510) 832-6131
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ82873Z
—
CA
Enumeration date
08/31/2006
Last updated
01/30/2008
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