CHABOT NEPHROLOGY MEDICAL GROUP, INC (NPI# 1912958422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912958422 |
| Entity Type | Organization |
| Organization Name | CHABOT NEPHROLOGY MEDICAL GROUP, INC |
| Practice Address |
13851 E 14th St 206 San Leandro CA 94578-2631 |
| Mailing Address |
101 Callan Ave Suite 402 San Leandro CA 94577-4584 |
| Practice Telephone | 5103519373 |
| Practice Fax Number | 5103510616 |
| Mailing Telephone | 5103511663 |
| Mailing Fax Number | 5103511035 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-12-05 |
| Authorized Official Name | JULIE ARMSTRONG (BILLING ADMINISTRATOR) |
| Authorized Official Telephone | 5103511669 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BRENDA PATRICK, NP | 271955 | 01 |
| CA | GR0045151 | 05 | |
| CA | GR0045150 | 05 | |
| CA | BLUESHIELD | ZZZ05207Z | 01 |
| Street Address |
13851 E 14TH ST 206 |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-2631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558333443 | Kenneth R Harley | Emergency Medicine | 13851 E 14th St, Suite 102, San Leandro, CA 94578-2631 | 2006-02-03 |
| 1720447782 | Byoung Wook Min | Acupuncturist | 13851 E 14th St, Suite 203, San Leandro, CA 94578-2631 | 2016-02-18 |
| 1477826444 | Kelley Bradshaw | Dietitian, Registered | 13851 E 14th St, Suite 102, San Leandro, CA 94578-2631 | 2012-02-21 |
| 1972808384 | Peak Foot and Ankle Specialists, Inc | Podiatrist | 13851 E 14th St, Ste 308, San Leandro, CA 94578-2631 | 2011-01-14 |
| 1700082179 | William Chow Do | Clinic/Center | 13851 E 14th St, Suite 308, San Leandro, CA 94578-2631 | 2007-06-22 |
| 1073646733 | Jamie Stonick | Optometrist | 13851 E 14th St, San Leandro, CA 94578-2631 | 2007-03-13 |
| 1083764179 | James W. Kurkjian | Psychologist | 13851 E 14th St, Ste. 203, San Leandro, CA 94578-2631 | 2007-01-11 |
| 1013016724 | Elena Beider | Physician Assistant | 13851 E 14th St, Suite 102, San Leandro, CA 94578-2631 | 2006-09-21 |
| 1275646721 | Herbert B Weingard | Family Medicine | 13851 E 14th St, Suite 200, San Leandro, CA 94578-2631 | 2006-08-17 |
| 1598786790 | C. Michael Neuwelt | Internal Medicine | 13851 E 14th St, Ste 301, San Leandro, CA 94578-2631 | 2006-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164997581 | Petra Jerman | Specialist | 272 Harlan St, San Leandro, CA 94577-5817 | 2018-10-11 |
| 1003305236 | East Bay Hand Medical Center, Inc | Specialist | 13690 E 14th St Ste 200, San Leandro, CA 94578-2584 | 2018-05-03 |
| 1801169149 | Gloria Ford | Specialist | 16378 E 14th St Ste 202, San Leandro, CA 94578-5122 | 2012-02-16 |
| 1891930673 | East Bay Rheumatology Medical Group, Inc. | Specialist | 13851 E 14th St Ste 301, San Leandro, CA 94578-2630 | 2008-12-09 |
| 1962544577 | Chester Julius Randle Jr. | Specialist | 2121 George Mark Ln, San Leandro, CA 94578-1017 | 2007-02-12 |
| 1588695167 | Robin Dell Fross | Specialist | 2500 Merced Street - Suite 208, Kaiser - Permanente Medical Center, Department of Nephr, San Leandro, CA 94577 | 2006-07-05 |
| 1023663051 | Kelsey Danielle Scott | Specialist | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2019-08-06 |
| 1508341835 | Patrick Alan Davies | Specialist | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2018-10-02 |
| 1417436403 | Alicia Rosalia Barron | Specialist | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2018-08-09 |
| 1043798374 | Camille Amanda Verbera | Specialist | 2275 Arlington Dr, San Leandro, CA 94578-1132 | 2018-07-30 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
Please comment or provide details below to improve the information on CHABOT NEPHROLOGY MEDICAL GROUP, INC.
| 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.