NPIMap

Organization Active NPI

Lifelong Medical Care

  • Clinic/Center
  • Berkeley, CA
National Provider Identifier
1073405429
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFELONG MEDICAL CARE
Practice address
830 University Ave
Berkeley, CA 94710-2044
Phone
(916) 749-6192
NPI assigned
Jul 18, 2025
Last updated
Jul 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brent Copen
Title
Cfo
Phone
(610) 918-4122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

830 University Ave
Berkeley, CA 94710-2044

Mailing address

2344 6TH St
Berkeley, CA 94710-2412
Phone (916) 749-6192

Other names 1

  • Berkeley Trust Other name

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Medical44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

830 University Ave
Berkeley, CA 94710
Phone (510) 981-5350

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1073405429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102412",
            "telephone_number": "916-749-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 UNIVERSITY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102044",
            "telephone_number": "916-749-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "COPEN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "610-918-4122"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berkeley Trust",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.