NPIMap

Organization Active NPI

Allergy and Immunology Clinic of East Bay Inc

  • Allergy & Immunology Physician
  • Berkeley, CA
National Provider Identifier
1477879609
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A83416 Issued in CA
Legal business name
ALLERGY AND IMMUNOLOGY CLINIC OF EAST BAY INC
Practice address
2320 Woolsey St
Ste 314
Berkeley, CA 94705-1973
Phone
(925) 270-5119
NPI assigned
Apr 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Dmitriy Sukhov
Title
Business Manager
Phone
(925) 270-5119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X A83416 CA Primary

Addresses

Primary practice location

2320 Woolsey St
Ste 314
Berkeley, CA 94705-1973

Mailing address

2320 Woolsey St
Ste 314
Berkeley, CA 94705-1973

National Provider Directory

National Provider Directory

Locations

2320 Woolsey St
Ste 314
Berkeley, CA 94705
Phone (510) 984-6500

NPI Registry JSON

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1477879609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 WOOLSEY ST",
            "address_2": "STE 314",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 WOOLSEY ST",
            "address_2": "STE 314",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051973",
            "telephone_number": "925-270-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND IMMUNOLOGY CLINIC OF EAST BAY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "SUKHOV",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "925-270-5119"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A83416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.