Berkeley Orthopaedic Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BERKELEY ORTHOPAEDIC MEDICAL GROUP, INC.

Practice address

3010 Colby St
Suite 118
Berkeley, CA 94705-2059

Phone

(510) 845-3856

Fax

(510) 845-1936

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Debenham, M.D.

Title

President

Phone

(510) 845-3856

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184840555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 COLBY STREET",
            "address_2": "SUITE 118",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94705",
            "telephone_number": "510-845-3856",
            "fax_number": "510-845-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 COLBY ST",
            "address_2": "SUITE 118",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052059",
            "telephone_number": "510-845-3856",
            "fax_number": "510-845-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY ORTHOPAEDIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEBENHAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-845-3856",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.