Howard D. Backer, MD

Individual provider Active NPI Emergency Medicine Physician · Berkeley, CA

NPI 1962580712 · NPPES record last updated Sep 19, 2020

Key facts

NPI
1962580712
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
G31950 (CA)
Practice address
2222 Bancroft Way
Berkeley, CA 94720-4235
Phone
(510) 642-6621
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G31950CAMDEmergency Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G31950 CA Yes

Addresses

Primary practice location

2222 Bancroft Way
Berkeley, CA 94720-4235

Mailing address

1800 Harrison St FL 7
Oakland, CA 94612-3429
Phone (510) 625-6262

Other identifiers

IdentifierTypeStateIssuer
00G319500MedicaidCA

Other providers in Berkeley, CA

All providers in Berkeley, CA · Emergency Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.