Organization
EAST BAY NEPHROLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A TURNER (CHIEF OPERATING OFFICER)
(510) 841-0411
Entity
Organization
Contact information
Practice address
2905 TELEGRAPH AVE, BERKELEY, CA 94705-2063
(510) 841-4525
(510) 848-9970
Mailing address
2905 TELEGRAPH AVE, BERKELEY, CA 94705-2063
(510) 841-4525
(510) 848-9970
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
—
GR0049640
—
CA
Enumeration date
09/15/2006
Last updated
07/21/2022
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