Berkeley Pediatric Medical Group, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BERKELEY PEDIATRIC MEDICAL GROUP, INC.

Practice address

1650 Walnut St
Berkeley, CA 94709-1606

Phone

(510) 848-2566

NPI assigned

Jul 16, 2006

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

Eydie Talavera

Title

Practice Administrator

Phone

(510) 848-2566

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407873425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 WALNUT ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091606",
            "telephone_number": "510-848-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 WALNUT ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091606",
            "telephone_number": "510-848-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY PEDIATRIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TALAVERA",
        "authorized_official_first_name": "EYDIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "510-848-2566"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Berkeley Holistic Therapy, a Marriage and Family Therapy Corporation
• Berkeley Mental Health
• Berkeley Orthopaedic Medical Group, Inc.
• Berkeley Physical Therapy Inc
• Berkeley Pines Care Center, Inc.
• Berkeley Pines Skilled Nursing Group, Inc.
• Berkeley Primary Care Medical Corporation
• Berkeley Therapy Institute

• Pediatrics Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pediatrics Physician 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.