East Bay Gastroenterology Medical Group, Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

EAST BAY GASTROENTEROLOGY MEDICAL GROUP, INC.

Practice address

350 30TH St
Suite 305
Oakland, CA 94609-3424

Phone

(510) 832-2767

Fax

(510) 832-6713

NPI assigned

Feb 8, 2007

Last updated

Aug 22, 2020By 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

Dr. Harvey W Olsen, M.D.

Title

President

Phone

(510) 832-2767

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881734515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 305",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-832-2767",
            "fax_number": "510-832-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 30TH ST",
            "address_2": "SUITE 305",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093424",
            "telephone_number": "510-832-2767",
            "fax_number": "510-832-6713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY GASTROENTEROLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-832-2767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Bay Community Recovery Project
• East Bay Community Recovery Project
• East Bay Doula Sisters
• East Bay Endosurgery Center Inc (East Bay Endosurgery Center)
• East Bay Family Practice Medical Group Inc
• East Bay Longevity Assisted Living LLC
• East Bay Nephrology Medical Group, Inc
• East Bay Newborn Specialists, Inc.
• East Bay Ophthalmic Anesthesia Inc
• East Bay Orthopaedic Specialists Medical Corporation

• Gastroenterology Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Gastroenterology Physician in California

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.