NEUROLOGY MED ASSOCS CHO (NPI# 1225164510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225164510 |
| Entity Type | Organization |
| Organization Name | NEUROLOGY MED ASSOCS CHO |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Mailing Address |
3116 W March Ln Ste 200 Stockton CA 95219-2369 |
| Practice Telephone | 5104283590 |
| Practice Fax Number | 5106013974 |
| Mailing Telephone | 2094736555 |
| Mailing Fax Number | 2094736543 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DANIEL BIRNBAUM (HEAD OF DEPT) |
| Authorized Official Telephone | 5104283590 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
G49267 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DR BIRNBAUM'S CA MD LIC | G49267 | 01 |
| CA | MEDI-CAL | GR0094870 | 01 |
| Street Address |
747 52ND ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| 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 | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306406467 | Debra Nipp | Pediatrics | 1661 Tice Valley Blvd Ste 100, Walnut Creek, CA 94595-1691 | 2019-06-19 |
| 1275979973 | Kartzinel Wellness Center Inc. | Pediatrics | 16263 Laguna Canyon Rd, Suite 150, Irvine, CA 92618-3609 | 2013-05-21 |
| 1528332905 | Pantea Sharifi Hannauer, M.d. Inc. | Pediatrics | 3524 Torrance Blvd., Suite 104, Torrance, CA 90503 | 2012-03-01 |
| 1891098422 | Bayard Allmond Jr. | Pediatrics | 36 Hillcrest Rd, Berkeley, CA 94705-2807 | 2010-12-21 |
| 1366654774 | Arleen Leann House Downing | Pediatrics | 2313 Old Grand St, Santa Ana, CA 92705-6967 | 2007-05-06 |
| 1427176700 | Suzanne Goh-hattangadi | Pediatrics | 7090 Miratech Dr, San Diego, CA 92121-3109 | 2007-03-26 |
| 1861552713 | Georgia Rae Prentice | Pediatrics | 26451 Crown Valley Pky, Mission Viejo, CA 92691 | 2006-12-11 |
| 1972615227 | Paul Michael Chretien | Pediatrics | 1111 Exposition Blvd., Bldg 700, Ste 102, Sacramento, CA 95815-4335 | 2006-08-31 |
| 1386753093 | Howard L Wolfinger Jr. | Pediatrics | 4355 Ruffin Rd, San Diego, CA 92123-4306 | 2006-08-29 |
| 1790292605 | Sana Khan | Pediatrics | 5820 Stoneridge Mall Rd Ste 205, Pleasanton, CA 94588-3347 | 2018-01-02 |
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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.