BERKELEY CARDIOVASCULAR MEDICAL GROUP (NPI# 1194746057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194746057 |
| Entity Type | Organization |
| Organization Name | BERKELEY CARDIOVASCULAR MEDICAL GROUP |
| Practice Address |
3300 Webster St Ste 702 Oakland CA 94609-3122 |
| Practice Telephone | 5105494220 |
| Practice Fax Number | 5104330744 |
| Mailing Telephone | 5105494220 |
| Mailing Fax Number | 5104330744 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-02-03 |
| Authorized Official Name | JOHN S EDELEN (PRESIDENT) |
| Authorized Official Telephone | 5105494220 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
CA | Allopathic & Osteopathic Physicians | |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0025432 | 05 | |
| CA | GR0025433 | 05 | |
| CA | GR0025431 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3466 Mt Diablo Blvd Ste C100, Lafayette, CA 945493952 | 9252833300 | 5104330744 |
| 3466 Mt Diablo Blvd Ste C100, Lafayette, CA 945493952 | 5105494220 | 5104330744 |
| 345 9th St Ste 205, Oakland, CA 946074206 | 5105494220 | 5104330744 |
| Street Address |
3300 WEBSTER ST STE 702 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720595564 | University Healthcare Alliance | Internal Medicine | 388 9th St Ste 250, Oakland, CA 94607-4294 | 2018-01-02 |
| 1679998504 | Sam Teichman | Internal Medicine | 631 Hillgirt Cir, Oakland, CA 94610-3708 | 2014-03-01 |
| 1962582189 | Rollington Ferguson | Internal Medicine | 368 28th Street, Suite A, Oakland, CA 94609-3601 | 2006-10-16 |
| 1922003862 | Earl Louis Holloway IIi | Internal Medicine | 3318 Elm St, Ste 2, Oakland, CA 94609-3013 | 2005-06-16 |
| 1477710671 | Dorinna D. Mendoza | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2008-05-16 |
| 1336317205 | Earl L. Holloway, M.d., Inc | Internal Medicine | 3318 Elm St, Oakland, CA 94609-3012 | 2008-02-13 |
| 1043438179 | Kavita V. Ernst | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2007-04-23 |
| 1730258179 | Ronald K Szeto | Internal Medicine | 3100 Telegraph Ave, Suite 4103, Oakland, CA 94609-3210 | 2006-11-07 |
| 1245318344 | Rebecca J. Doane | Internal Medicine | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-11-02 |
| 1649359787 | David L. Shearn | Internal Medicine | 1950 Franklin St, Oakland, CA 94612-5103 | 2006-11-02 |
| Find all providers in OAKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.