DR. LEROY EVAN CUSTER (NPI# 1538104179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538104179 |
| Entity Type | Individual |
| Full Name | DR. LEROY EVAN CUSTER |
| Credential | M.D. |
| Practice Address |
2450 Ashby Ave Berkeley CA 94705-2067 |
| Mailing Address |
175 Lennon Ln Suite 100 Walnut Creek CA 94598-2485 |
| Practice Telephone | 9252967156 |
| Practice Fax Number | 9252967174 |
| Mailing Telephone | 9252967156 |
| Mailing Fax Number | 9252967174 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2009-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G12559 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2450 ASHBY AVE |
| City | BERKELEY |
| State | CA |
| Zip Code | 94705-2067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366447369 | Henry Hinchung Tan | Internal Medicine | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2005-06-16 |
| 1154940286 | Kassandra Marie Donnels | Advanced Practice Midwife | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2020-04-09 |
| 1881221646 | Stephanie Miller | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2020-03-23 |
| 1962966689 | Samantha Ann Misslbeck | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2019-01-27 |
| 1851898837 | Obianauju Vivian Ogu | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2018-04-06 |
| 1033649579 | Robert Michael Roth | Emergency Medicine | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2017-06-18 |
| 1306294962 | Anh Dang | General Acute Care Hospital | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2016-05-24 |
| 1639523004 | Sutter Bay Hospitals | Clinical Medical Laboratory | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2016-04-21 |
| 1316312648 | Zain Daniel Bartlett Morin | Pharmacist | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2015-12-11 |
| 1841663804 | Ilana Rose Pearlman | Advanced Practice Midwife | 2450 Ashby Ave, Rm. 3040, Berkeley, CA 94705-2067 | 2015-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882956 | Diane Lomas Wyatt | Marriage & Family Therapist | 2340 Ward St. Ste 104, Berkeley, CA 94705 | 2020-02-12 |
| 1700371275 | Icecreamwala Dermatology Inc | Dermatology | 2435 Webster St Ste 101, Berkeley, CA 94705 | 2018-06-27 |
| 1396253803 | David R Shaddock | Marriage & Family Therapist | 3030 Ashby Avenue, # 105, Berkeley, CA 94705 | 2018-01-18 |
| 1821504432 | Allegra Tringali | Physical Therapist | 2450 Ashby Ave Fl 6, Berkeley, CA 94705 | 2017-12-19 |
| 1659898740 | Hunter Brown | Student in an Organized Health Care Education/Training Program | Wright Institute Clinical Services 1918 University Ave, Suite 2b, Berkeley, CA 94705 | 2017-08-29 |
| 1588014534 | Heather Valdez | Social Worker | 2185 Ashby Ave, Berkeley, CA 94705 | 2016-06-20 |
| 1215350145 | S.e.e.d.s. (social and Emotional Education Development and Support) | Community/Behavioral Health | 3120 Telegraph Avenue Ste 9, Berkeley, CA 94705 | 2014-01-29 |
| 1144580960 | Benjamin Tucker | Counselor | 2625 Alcatraz Ave Ste 609, Berkeley, CA 94705 | 2012-05-26 |
| 1881966141 | Jennifer Cowherd | Behavioral Analyst | 2201 Woolsey St, Berkeley, CA 94705 | 2012-02-02 |
| 1518255892 | Erika D Huguenard | Counselor | 2811a College Avenue, Berkeley, CA 94705 | 2011-07-20 |
| Find all providers in zip 94705 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982193512 | Bay Imaging Consultants Medical Group Inc | Radiology | 3100 San Pablo Ave Ste 330, Berkeley, CA 94702-2498 | 2018-05-09 |
| 1477790913 | Kobi Ledor | Radiology | 55 Vicente Rd, Berkeley, CA 94705-1603 | 2009-01-20 |
| 1073701967 | Peggy Shih-pei Wu | Radiology | 2312 Russell St, Berkeley, CA 94705-1926 | 2007-10-04 |
| 1639217904 | Pet-ct Imaging of Berkeley, LLC | Radiology | 2855 Telegraph Ave Ste 100, Berkeley, CA 94705-1149 | 2007-02-01 |
| 1336182757 | Alfred L Horowitz | Radiology | 927 Euclid Ave, Berkeley, CA 94708-1449 | 2006-06-14 |
| 1881971299 | Norcal Imaging | Radiology | 2999 Regent St., Suite 225, Berkeley, CA 94705-2117 | 2011-11-14 |
| 1508009846 | Alta Ct Services A California Limited Partnership | Radiology | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2009-04-16 |
| 1992958847 | Bay Imaging Consultants Medical Group | Radiology | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2008-10-23 |
| 1871749754 | Bay Imaging Consultants Medical Group Inc | Radiology | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2008-08-12 |
| 1700032802 | Bay Imaging Consultants Medical Group Inc | Radiology | 2001 Dwight Way, Berkeley, CA 94704-2608 | 2008-08-08 |
| Find all providers in BERKELEY | ||||
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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.