RICHARD L WACHT MD MEDICAL CORP (NPI# 1922010487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922010487 |
| Entity Type | Organization |
| Organization Name | RICHARD L WACHT MD MEDICAL CORP |
| Practice Address |
419 30th St Oakland CA 94609-3303 |
| Practice Telephone | 5104444305 |
| Practice Fax Number | 5104446356 |
| Mailing Telephone | 5104444305 |
| Mailing Fax Number | 5104446356 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2008-09-29 |
| Authorized Official Name | DR. RICHARD LEE WACHT (OWNER) |
| Authorized Official Telephone | 5104444305 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | A021202 | CA | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | A021202 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 719 4316 | 05 | |
| STATE TAX ID | 21464656 | 01 | |
| CA | CA CORP # | 0754737 | 01 |
| Street Address |
419 30TH ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447246293 | Noha Mandouh Aboelata | Family Medicine | 419 30th St, Suite D, Oakland, CA 94609-3301 | 2005-09-26 |
| 1821467077 | Hyo Jin Jennifer Min | Registered Nurse | 419 30th St, Oakland, CA 94609-3374 | 2015-09-17 |
| 1295062164 | Isis Health Center, Inc | Clinic/Center | 419 30th St, Suite D, Oakland, CA 94609-3374 | 2009-11-12 |
| 1356418958 | Summit Podiatry Group | Podiatrist | 419 30th St, Suite A, Oakland, CA 94609-3301 | 2006-11-29 |
| 1831131309 | Karl Robert Coulter | Podiatrist | 419 30th St, Suite A, Oakland, CA 94609-3301 | 2006-06-11 |
| 1720047376 | Richard L Wacht | Allergy & Immunology | 419 30th St, Oakland, CA 94609-3301 | 2006-03-22 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1114491743 | Kimberly Hicks M D Inc | Internal Medicine | 3317 Elm St Ste 102, Oakland, CA 94609-3053 | 2019-01-16 |
| 1457718736 | John Flaningam | Internal Medicine | 11 Hillcrest Ct, Oakland, CA 94619-2411 | 2016-01-18 |
| 1861822819 | Harold Orr Jr. | Internal Medicine | 11100 Kerrigan Dr, Oakland, CA 94605-5414 | 2013-11-12 |
| 1245672815 | Abdul Wasay Raif Jawid | Internal Medicine | 1401 E 31st St, Oakland, CA 94602 | 2013-07-24 |
| 1255605192 | James Pickett Seward | Internal Medicine | 5493 Taft Ave, Oakland, CA 94618-1501 | 2012-02-23 |
| 1265719033 | My Health Medical Group Inc | Internal Medicine | 1221 Broadway Fl 7, Oakland, CA 94612-1837 | 2011-11-08 |
| 1720376395 | Lisa Jane Chandler | Internal Medicine | 5433 Thomas Ave, Oakland, CA 94618-1749 | 2011-07-18 |
| 1679872444 | Mitchell Liverant | Internal Medicine | 3600 Broadway Fl 2, Oakland, CA 94611-5730 | 2011-03-19 |
| 1770880163 | Astha Kanani | Internal Medicine | 3451 E 12ths St, Oakland, CA 94601-3463 | 2011-02-21 |
| 1861705725 | Jose A Lopez M.d P.a | Internal Medicine | 30 Remington Rd, Suite 2, Oakland, FL 34787-9797 | 2010-07-21 |
| 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.