Runa Basu, D.O.
Individual provider Active NPI Internal Medicine Physician · Berkeley, CA
NPI 1245471689 · NPPES record last updated Mar 16, 2009
Key facts
- NPI
- 1245471689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2OA6804 (CA)
- Practice address
- 1524 Fairview St
Berkeley, CA 94703-2318 - Phone
- (510) 771-3000
- Fax
- (510) 550-2555
- NPI assigned
- Mar 16, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 5, 2019 through Feb 5, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6804 | CA | MD | Optometrist |
| 2OA6804 | CA | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2OA6804 | CA | Yes |
Addresses
Primary practice location
1524 Fairview St
Berkeley, CA 94703-2318
Mailing address
1524 Fairview St
Berkeley, CA 94703-2318
Phone (510) 771-3000
Other providers in Berkeley, CA
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- Aaron David Bass-Cetinich
- Amanda Bassard
- Kelly Anne Bassin
- Kathryn Rae Bastable
- James P Bates
- Bath Chiropractic Inc.
- Jaskiran Kaur Bath
- Jennifer Bath
- E.Anthony N Batoon
All providers in Berkeley, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.