East Bay Medical Oncology-Hematology Associates

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

G39816 Issued in CA

Legal business name

EAST BAY MEDICAL ONCOLOGY-HEMATOLOGY ASSOCIATES

Practice address

4721 Dallas Ranch Rd
Antioch, CA 94531-8811

Phone

(925) 778-0679

Fax

(925) 778-3567

NPI assigned

Apr 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Phelps Jackson

Title

Ceo

Phone

(925) 771-1404

Specialties & licenses 1

Addresses

Other names 1

• Epic Care Doing business as

Tax ID family

Donna E Foliart MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• East Bay Medical Oncology/Hematology Associates, Inc.

  • Community Based Hospice Care Agency
  • Antioch, CA
  • NPI 1083025779
  NPD tax ID

Locations

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1972776730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 DALLAS RANCH RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318811",
            "telephone_number": "925-778-0679",
            "fax_number": "925-778-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4721 DALLAS RANCH RD",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318811",
            "telephone_number": "925-778-0679",
            "fax_number": "925-778-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY MEDICAL ONCOLOGY-HEMATOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "PHELPS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-771-1404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "G39816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Epic Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth Reid Dupree, D. M. D.
• Nyccol Dupree
• Alyssa Durjava
• Ernest Chimeziem Durunna Jr.
• East Bay Health Care Support Services, Inc.
• East Bay Medical Oncology-Hematology Associates, Inc.
• East Bay Medical Oncology/Hematology Associates, Inc.
• East Bay Mens Recovery Center
• East Bay Physical Therapy, Inc.
• East Bay Surgical Associates, a Medical Corporation

• Hospice and Palliative Medicine (Family Medicine) Physician in Antioch, CA
• Providers in Antioch, CA by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.