East Bay Vascular Medical Group

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

EAST BAY VASCULAR MEDICAL GROUP

Practice address

365 Hawthorne Ave
Suite 103
Oakland, CA 94609-3107

Phone

(510) 832-6131

NPI assigned

Aug 31, 2006

Last updated

Jan 30, 2008By 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

Nanci Carter Webb

Title

Practice Manager

Phone

(510) 832-6131

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1861503351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "SUITE 103",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093107",
            "telephone_number": "510-832-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "SUITE 103",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093107",
            "telephone_number": "510-832-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY VASCULAR MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "NANCI",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "510-832-6131"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ82873Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Bay Retina Consultants a Medical Group, Inc. (East Bay Retina Consultants, Inc.)
• East Bay Sleep Management
• East Bay Special Imaging
• East Bay Special Imaging Medical Group, Inc. (East Bay Special Imaging)
• East Bay Special Surgery LLC
• East Bay Vision Center Optometry Inc
• East Bay Vision Center Optometry Inc
• East Bay Women's Health, Inc
• East Oakland Community Project
• East Oakland Obs GYN Med GP Inc

• Vascular Surgery Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.