NPIMap

Organization Active NPI

California State University East Bay

  • Clinic Pharmacy
  • Hayward, CA
National Provider Identifier
1992805949
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PHE17358 Issued in CA
Legal business name
CALIFORNIA STATE UNIVERSITY EAST BAY
Practice address
25800 Carlos Bee Blvd
Hayward, CA 94542-3000
Phone
(510) 885-3650
Fax
(510) 885-7477
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Robert Mar
Title
Pic
Phone
(510) 885-3650

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X PHE17358 CA Primary

Addresses

Primary practice location

25800 Carlos Bee Blvd
Hayward, CA 94542-3000

Mailing address

25800 Carlos Bee Blvd
Hayward, CA 94542-3000
Phone (510) 885-3650

Other identifiers 1

IdentifierTypeStateIssuer
2047984OtherPK

Other names 1

  • CALIFORNIA STATE UNIVERSITY EAST BAY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
California State University East Bay3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1992805949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25800 CARLOS BEE BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945423000",
            "telephone_number": "510-885-3650",
            "fax_number": "510-885-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25800 CARLOS BEE BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945423000",
            "telephone_number": "510-885-3650",
            "fax_number": "510-885-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY EAST BAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "MAR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "510-885-3650"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "CA",
            "license": "PHE17358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047984",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALIFORNIA STATE UNIVERSITY EAST BAY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayward, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.