Active NPI
Marcia E. Charles-Mo, M.D.
- Pediatrics Physician
- Berkeley, CA
National Provider Identifier
1710071154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G47840
- Practice address
- 2999 Regent Street
Suite 325
Berkeley, CA 94705-2118 - Phone
- (925) 254-9203
- Fax
- (510) 841-5650
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G47840 | CA | Primary |
Addresses
Primary practice location
2999 Regent Street
Suite 325
Berkeley, CA 94705-2118
Mailing address
2999 Regent Street
Suite 325
Berkeley, CA 94705-2118
Phone (925) 254-9203
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47840 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alta Bates Summit Medical Center | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients | |
| UCSF Health Medical Foundation | Past | Accepting new patients | |
| East Bay Pediatrics Medical Group | Pediatrics | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710071154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2999 REGENT STREET",
"address_2": "SUITE 325",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052118",
"telephone_number": "925-254-9203",
"fax_number": "510-841-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2999 REGENT STREET",
"address_2": "SUITE 325",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052118",
"telephone_number": "925-254-9203",
"fax_number": "510-841-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHARLES-MO",
"first_name": "MARCIA",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G47840",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.