Organization Active NPI

Carbon Health East Bay Medical Group PC

  • Urgent Care Clinic/Center
  • Antioch, CA
National Provider Identifier
1972243574
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CARBON HEALTH EAST BAY MEDICAL GROUP PC
Practice address
5829 Lone Tree Way # D110
Antioch, CA 94531-8603
Phone
(925) 204-3715
Fax
(888) 972-1912
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Kaitlin Boyle
Title
Director
Phone
(303) 601-5392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

5829 Lone Tree Way # D110
Antioch, CA 94531-8603

Mailing address

300 California St FL 7
San Francisco, CA 94104-1415

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
05D2265114Carbon Health Medical Group of California PC5829 Lone Tree Way Suite D, Antioch, CA 94531Certificate of waiverJul 21, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1972243574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CALIFORNIA ST FL 7",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941041415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5829 LONE TREE WAY # D110",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318603",
            "telephone_number": "925-204-3715",
            "fax_number": "888-972-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBON HEALTH EAST BAY MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "KAITLIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-601-5392"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.