EMERGENCY MED ASSOC CHO (NPI# 1770618027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770618027 |
| Entity Type | Organization |
| Organization Name | EMERGENCY MED ASSOC CHO |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Mailing Address |
3116 W March Ln Ste 200 Stockton CA 95219-2369 |
| Practice Telephone | 5104283259 |
| Practice Fax Number | 5104505836 |
| Mailing Telephone | 2094736555 |
| Mailing Fax Number | 2094736543 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY RUTHERFORD (HEAD OF DEPT) |
| Authorized Official Telephone | 5104283259 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
G43608 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | GR0095780 | 01 |
| CA | DR. RUTHERFORD'S CA MD LI | G43608 | 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 | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] 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 |
|---|---|---|---|---|
| 1205360591 | Mukuka Kangwa | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2017-04-13 |
| 1780720474 | Sima Patel | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2007-01-29 |
| 1821158874 | Lydia Magavern Shrestha | Pediatrics | 747 52nd St, Childrens Hospital Oakland Ed 2, Oakland, CA 94609 | 2006-12-11 |
| 1053490490 | Casilda Jean Rubio | Pediatrics | 747 52nd St, Emergency Department, Children's Hospital Oakland, Oakland, CA 94609-1809 | 2006-11-05 |
| 1407932676 | Mary Workman Rutherford | Pediatrics | 747 52nd St, Childrens Hospital Oakland Emergency Department, Oakland, CA 94609-1809 | 2006-10-31 |
| 1760582217 | Ellen L Henderson | Pediatrics | 747 52nd St, Childrens Hosp Oakland, Oakland, CA 94609 | 2006-09-25 |
| 1750484374 | Augusta J Saylys | Pediatrics | 747 52nd St, Emerg Dept Childrens Hosp & Research Center At Oakland, Oakland, CA 94609-1809 | 2006-09-07 |
| 1679685440 | Alan Mark Johnson | Pediatrics | 747 52nd Street, Emergency Medicine, Oakland, CA 94609-1809 | 2006-08-31 |
| 1790791242 | Donald Demetrios Zukin | Pediatrics | 747 52nd St, Chrco Emergency Dept, Oakland, CA 94609-1809 | 2006-08-01 |
| 1447273248 | Lisa Sinclair Hart | Pediatrics | 747 52nd St, Children's Hospital Oakland Emergency Department, Oakland, CA 94609-1809 | 2006-07-25 |
| 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.