Eden Laboratories Medical Group

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EDEN LABORATORIES MEDICAL GROUP

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5341

Phone

(510) 889-5036

NPI assigned

Apr 4, 2006

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

Kenneth Leipper, MD

Title

President

Phone

(510) 889-5036

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sharon Ann Dewit, MD

  • Nuclear Medicine Physician
  • Fremont, CA
  • NPI 1881656957

  Cytopathology

  NPD (past)
• Meena Tandon, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Fremont, CA
  • NPI 1194787770

  Cytopathology

  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982666053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10076",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914100076",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465341",
            "telephone_number": "510-889-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN LABORATORIES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIPPER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-889-5036",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0014940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Analise Marie Eastman Hawkins, MS, FNP
• Lucy Edeh, LVN
• Robert Edelman, M.D.
• Eden Counseling Services
• Eden Emergency Medical Group Inc
• Eden Medical Center
• Eden Medical Center
• Larissa Edwards, MSW
• Rochelle Ana Eggleston Philapil, MD
• Beth L Ehrlich, AUD

• Clinical Medical Laboratory in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Clinical Medical Laboratory 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.
• 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.