NPIMap

Organization Active NPI

Family Practice Medical Group of Oakland

  • Family Medicine Physician
  • Oakland, CA
National Provider Identifier
1649234865
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY PRACTICE MEDICAL GROUP OF OAKLAND
Practice address
350 30TH St
Suite 407
Oakland, CA 94609-3425
Phone
(510) 419-0230
Fax
(510) 419-0440
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Careen Renee Whitley, MD
Title
President
Phone
(510) 419-0230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

350 30TH St
Suite 407
Oakland, CA 94609-3425

Mailing address

350 30TH St
Suite 407
Oakland, CA 94609-3425
Phone (510) 419-0230

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ45714ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

3100 Telegraph Ave
Fl 4
Oakland, CA 94609
Phone (510) 419-0230

3100 Telegraph Ave
Ste 4100
Oakland, CA 94609
Phone (510) 419-0230

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1649234865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 407",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093425",
            "telephone_number": "510-419-0230",
            "fax_number": "510-419-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 407",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093425",
            "telephone_number": "510-419-0230",
            "fax_number": "510-419-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE MEDICAL GROUP OF OAKLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "WHITLEY",
        "authorized_official_first_name": "CAREEN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-419-0230",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ45714Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.