Active NPI
Eden Medical Center
- General Acute Care Hospital
- San Leandro, CA
National Provider Identifier
1457317034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 140000030
- Legal business name
- EDEN MEDICAL CENTER
- Practice address
- 13855 E 14TH St
San Leandro, CA 94578-2611 - Phone
- (510) 357-6500
- NPI assigned
- Apr 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Ronnie Bayduza
- Title
- Administrator
- Phone
- (510) 667-4511
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 140000030 | CA | Primary |
Addresses
Primary practice location
13855 E 14TH St
San Leandro, CA 94578-2611
Mailing address
P.O. Box 60000, File 74500
San Francisco, CA 94160-0001
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HSC00264I | Medicaid | CA | |
| ZZR00264I | Medicaid | CA | |
| ZZZA0118Z | Other | CA | BLUE SHIELD |
| HSP40264I | Medicaid | CA | |
| 2082793 | Other | CA | AETNA |
Other names 1
- San Leandro Hospital
National Provider Directory
National Provider Directory- Tax ID family
- Eden Medical Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Acute Care Hospital
- Castro Valley, CA
- NPI 1134122179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294704000000",
"number": "1457317034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 60000, FILE 74500",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941600001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13855 E 14TH ST",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945782611",
"telephone_number": "510-357-6500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDEN MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-24",
"last_updated": "2011-01-11",
"status": "A",
"authorized_official_last_name": "BAYDUZA",
"authorized_official_first_name": "RONNIE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "510-667-4511",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "CA",
"license": "140000030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HSC00264I",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZR00264I",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZA0118Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HSP40264I",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2082793",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "San Leandro Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.