Organization Active NPI

North Oakland Medical Clinic a Professional Corp

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1285696062
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTH OAKLAND MEDICAL CLINIC A PROFESSIONAL CORP
Practice address
6105 San Pablo Ave
Oakland, CA 94608-2225
Phone
(510) 658-7660
Fax
(510) 658-5138
NPI assigned
Apr 5, 2006
Last updated
Nov 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Mrs. Anita L Thompson
Title
Administrator
Phone
(510) 658-7660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6105 San Pablo Ave
Oakland, CA 94608-2225

Mailing address

6105 San Pablo Ave
Oakland, CA 94608-2225
Phone (510) 658-7660

Other identifiers 1

IdentifierTypeStateIssuer
00C312110MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1285696062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 SAN PABLO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082225",
            "telephone_number": "510-658-7660",
            "fax_number": "510-658-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 SAN PABLO AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946082225",
            "telephone_number": "510-658-7660",
            "fax_number": "510-658-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OAKLAND MEDICAL CLINIC A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "510-658-7660",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C312110",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.