NPIMap

Organization Active NPI

East Bay Pediatrics Medical Group

  • Pediatrics Physician
  • Orinda, CA
National Provider Identifier
1811078017
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
EAST BAY PEDIATRICS MEDICAL GROUP
Practice address
96 Davis Rd
Suite 2
Orinda, CA 94563-3041
Phone
(925) 254-9203
Fax
(510) 841-5650
NPI assigned
Oct 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Richard L. Oken, M.D.NPI 1609988864
Title
Managing Partner
Phone
(925) 254-9203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

96 Davis Rd
Suite 2
Orinda, CA 94563-3041

Mailing address

96 Davis Rd
Orinda, CA 94563-3041
Phone (925) 254-9203

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0880264East Bay Pediatric Medical Group96 Davis Road, Suite 2, Orinda, CA 94563Certificate of waiverApr 3, 2028

National Provider Directory

National Provider Directory

Locations

96 Davis Rd
Ste 2
Orinda, CA 94563
Phone (925) 254-1054

Practitioners & affiliated clinicians

Practitioners 12

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811078017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 DAVIS RD",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633041",
            "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": "96 DAVIS RD",
            "address_2": "SUITE 2",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945633041",
            "telephone_number": "925-254-9203",
            "fax_number": "510-841-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PEDIATRICS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OKEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "925-254-9203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.