Alta East Bay Pathology Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

05D0599285 Issued in CA

Legal business name

ALTA EAST BAY PATHOLOGY INC

Practice address

20103 Lake Chabot Road
Castro Valley, CA 94546-5305

Phone

(510) 268-8683

Fax

(510) 268-8865

NPI assigned

Apr 8, 2009

Last updated

Apr 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Annette Shaieb, MDNPI 1558330068

Title

President

Phone

(805) 578-8300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Alta East Bay Pathology Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Oakland, CA
  • NPI 1932342854

  O20040426000754

  Same enrollment
• Alta East Bay Pathology, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Berkeley, CA
  • NPI 1003878240

  O20040426000754

  Same enrollment
• Alta East Bay Pathology, Inc.

  • Clinical Medical Laboratory
  • Oakland, CA
  • NPI 1316909559

  O20040426000754

  Same enrollment
• Alta East Bay Pathology, Inc.

  • Clinical Medical Laboratory
  • Oakland, CA
  • NPI 1578514196

  O20040426000754

  Same enrollment

Practitioners 3

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.

• Annette M Shaieb, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Berkeley, CA
  • NPI 1558330068
  Authorized official Same address or phone
• Lynne Lin-Chang, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Berkeley, CA
  • NPI 1770516536
  NPD
• Emily Anne O'Rourke, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Oakland, CA
  • NPI 1437492386
  NPD

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1811130727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 ERRINGER RD",
            "address_2": "1ST FLOOR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653583",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT ROAD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-268-8683",
            "fax_number": "510-268-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA EAST BAY PATHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "SHAIEB",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-578-8300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "05D0599285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.