Individual provider Active NPI

Charles A Obeng

  • Driver
  • Oakland, CA
National Provider Identifier
1699435107
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
2040 E 30TH St Apt 206
Oakland, CA 94606-3495
Phone
(510) 776-6148
NPI assigned
Dec 23, 2021
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Primary

Addresses

Primary practice location

2040 E 30TH St Apt 206
Oakland, CA 94606-3495

Mailing address

2040 E 30TH St Apt 206
Oakland, CA 94606-3495
Phone (510) 776-6148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1699435107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 E 30TH ST APT 206",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063495",
            "telephone_number": "510-776-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E 30TH ST APT 206",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946063495",
            "telephone_number": "510-776-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBENG",
        "first_name": "CHARLES",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-23",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 23, 2021; 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.