East Bay Surgical Associates Medical Group

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

EAST BAY SURGICAL ASSOCIATES MEDICAL GROUP

Practice address

1430 Tara Hills Dr
Ste D
Pinole, CA 94564-2580

Phone

(510) 724-5714

NPI assigned

Mar 14, 2007

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

Julie Merkt

Title

Office Manager

Phone

(510) 724-5714

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639203672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TARA HILLS DR",
            "address_2": "STE D",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642580",
            "telephone_number": "510-724-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TARA HILLS DR",
            "address_2": "STE D",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642580",
            "telephone_number": "510-724-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY SURGICAL ASSOCIATES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MERKT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "510-724-5714"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0058731",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miriam E. Dunham, MD
• Molly Nora Dymond, PT, DPT, NCS
• East Bay Chiropractic Health Center Dr Collins Inc (East Bay Chiropractic Health Center)
• East Bay Ophthalmology
• East Bay Sleep Medical Group
• Eastshore Pediatric Dental Group
• Edward Jang DDS Inc
• Gafra Elizzani, DDS
• Ellen a. Marzan Chiropractic, Inc. (Family Chiropractic Joint)
• Ilya Erenberg, M.A.

• Surgery Physician in Pinole, CA
• Providers in Pinole, CA by specialty
• Surgery 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.