NPIMap

Organization Active NPI

Laurel Grove Acute Hospital

  • General Acute Care Hospital
  • Castro Valley, CA
National Provider Identifier
1265680045
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
LAUREL GROVE ACUTE HOSPITAL
Practice address
19933 Lake Chabot Rd
Castro Valley, CA 94546-4003
Phone
(510) 537-1234
NPI assigned
Sep 4, 2008
Last updated
Sep 13, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
EDEN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Mr. George Derbedrosian
Title
Regional Director - PFS
Phone
(510) 869-6163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

19933 Lake Chabot Rd
Castro Valley, CA 94546-4003

Mailing address

3012 Summit St
4TH Floor
Oakland, CA 94609-3480
Phone (510) 869-6591

National Provider Directory

National Provider Directory
Tax ID family
Eden Medical Group4 organizations share this tax ID, including this one
Part of
Eden Medical Group

Other organizations with this tax ID 3

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

Locations

3012 Summit St
Fl 4
Oakland, CA 94609

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1265680045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 SUMMIT ST",
            "address_2": "4TH FLOOR",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093480",
            "telephone_number": "510-869-6591",
            "fax_number": "510-869-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19933 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464003",
            "telephone_number": "510-537-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL GROVE ACUTE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDEN MEDICAL CENTER",
        "enumeration_date": "2008-09-04",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "DERBEDROSIAN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR - PFS",
        "authorized_official_telephone_number": "510-869-6163",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.