481 ASC Project LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Oakland, CA
NPI 1447301593 · NPPES record last updated Jul 9, 2013
Key facts
- NPI
- 1447301593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 140000588 (CA)
- Legal business name
- 481 ASC PROJECT LLC
- Practice address
- 481 30TH St
Oakland, CA 94609-3209 - Phone
- (510) 835-4521
- Fax
- (510) 835-4223
- NPI assigned
- Jan 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Richard H. Lee, M.D.
- Title
- Medical Director
- Phone
- (510) 835-4521
Practitioners 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2004447 | Eye MD Laser & Surgery Center | Certificate of waiver | Mar 3, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050509001068 | CA | Part B Supplier - Ambulatory Surgical Center | 7416997473 | Practice locations: Oakland, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 140000588 | CA | Yes |
Addresses
Primary practice location
481 30TH St
Oakland, CA 94609-3209
Mailing address
481 30TH St
Oakland, CA 94609-3209
Phone (510) 835-4521
Other names
- Eye MD Laser & Surgery Center LLC
Other providers in Oakland, CA
- 1 Direction, LLC
- A Better Way, Inc.
- A Better Way, Inc.
- A Better Way, Inc.
- A Better Way, Inc.
- A Little Bean, LLC
All providers in Oakland, CA · Ambulatory Surgical Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2013. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.