East Bay Physician'S Medical Group

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95004006 Issued in CA

Legal business name

EAST BAY PHYSICIAN'S MEDICAL GROUP

Practice address

5700 Telegraph Ave
Oakland, CA 94609-1710

Phone

(510) 204-3986

Fax

(510) 204-3948

NPI assigned

Jul 21, 2016

Organization subpart

No

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

Authorized official

Name

Monica A. Reymundo

Title

Physical Services Supervisor

Phone

(510) 204-6660

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1184077463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091710",
            "telephone_number": "510-204-3986",
            "fax_number": "510-204-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091710",
            "telephone_number": "510-204-3986",
            "fax_number": "510-204-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PHYSICIAN'S MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "REYMUNDO",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PHYSICAL SERVICES SUPERVISOR",
        "authorized_official_telephone_number": "510-204-6660"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95004006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Bay Ophthalmic Anesthesia Inc
• East Bay Orthopaedic Specialists Medical Corporation
• East Bay Pain Care, Inc.
• East Bay Pediatric Cardiology Medical Group, Inc.
• East Bay Perinatal Medical Associates
• East Bay Primary Care Medical Group, Inc.
• East Bay Regional Critical Care and Pulmonary Medicine, Inc.
• East Bay Retina Consultants a Medical Group, Inc.
• East Bay Retina Consultants a Medical Group, Inc.
• East Bay Sleep Management

• Family Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.