Organization Active NPI

Lifelong Medical Care

  • Community Health Clinic/Center
  • Oakland, CA
National Provider Identifier
1780032128
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
336201 Issued in CA
Legal business name
LIFELONG MEDICAL CARE
Practice address
10700 Macarthur Blvd
Suite 14 B
Oakland, CA 94605-5298
Phone
(510) 932-1034
Fax
(510) 563-4387
NPI assigned
May 26, 2016
Last updated
May 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Eric Henly, MD
Title
Chief Medical Director
Phone
(510) 563-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 336201 CA Primary

Addresses

Primary practice location

10700 Macarthur Blvd
Suite 14 B
Oakland, CA 94605-5298

Mailing address

10700 Macarthur Blvd
Suite 14 B
Oakland, CA 94605-5298
Phone (510) 932-1034

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Medical Center44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1780032128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "address_2": "SUITE 14 B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055298",
            "telephone_number": "510-932-1034",
            "fax_number": "510-563-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "address_2": "SUITE 14 B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055298",
            "telephone_number": "510-932-1034",
            "fax_number": "510-563-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "HENLY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "510-563-4300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "CA",
            "license": "336201",
            "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 May 26, 2016; 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.