Arnold Greenberg MD Inc
Organization Active NPI Neurology Physician · Carmichael, CA
NPI 1700977188 · NPPES record last updated Apr 30, 2020
Key facts
- NPI
- 1700977188
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- ARNOLD GREENBERG MD INC
- Practice address
- 5810 Jameson CT
Ste 1
Carmichael, CA 95608 - Phone
- (916) 979-0621
- Fax
- (916) 979-1110
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Larisa Kravchuk
- Title
- Manager
- Phone
- (916) 979-0621
Practitioners 12
-
Pavel Polskiy, MD
-
Vladimir Rafanov, MD
-
Irina Shulgina, PAC
-
Arnold Greenberg, M.D.
-
Anna Roysman, MD
-
Tatyana Chursina, P.A.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0932652 | Arnold Greenberg MD Inc | Certificate of waiver | Jun 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040218000540 | CA | Part B Supplier - Clinic/Group Practice | 6507765971 |
Receives reassigned benefits from 10 practitioners Practice locations: Carmichael, CA |
National Provider Directory
Locations
5810 Jameson Ct
Ste 1
Carmichael, CA 95608
Phone (916) 979-0621
5810 Jameson Ct
Ste 5
Carmichael, CA 95608
Phone (916) 500-4510
804 Harbor Blvd
West Sacramento, CA 95691
Phone (415) 346-7505
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | |||
| Neurology Physician |
2084N0400X | Yes | ||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Physical Therapist |
225100000X |
Addresses
Primary practice location
5810 Jameson CT
Ste 1
Carmichael, CA 95608
Mailing address
5810 Jameson CT
Carmichael, CA 95608-0881
Phone (916) 979-0621
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0080910 | Medicaid | CA |
Other names
- Manzanita Medical Clinic
Other providers in Carmichael, CA
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- Erica L Arent
- Amy Vienna Arguello
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All providers in Carmichael, CA · Neurology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.