EDEN LABORATORIES MEDICAL GROUP (NPI# 1982666053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982666053 |
| Entity Type | Organization |
| Organization Name | EDEN LABORATORIES MEDICAL GROUP |
| Practice Address |
20103 Lake Chabot Rd Castro Valley CA 94546-5341 |
| Mailing Address |
Po Box 10076 Van Nuys CA 91410-0076 |
| Practice Telephone | 5108895036 |
| Mailing Telephone | 8055788300 |
| Mailing Fax Number | 8055788950 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KENNETH LEIPPER (PRESIDENT) |
| Authorized Official Telephone | 5108895036 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0014940 | 05 |
| Street Address |
20103 LAKE CHABOT RD |
| City | CASTRO VALLEY |
| State | CA |
| Zip Code | 94546-5341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134122179 | Eden Medical Center | General Acute Care Hospital | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2005-05-23 |
| 1902412430 | Kenneth A Harris | Registered Nurse | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2020-09-21 |
| 1417568916 | Michael A Esparza Md Inc | Surgery | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2020-08-10 |
| 1417596289 | Linda Ann Scott-hickman | Pharmacist | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2019-12-27 |
| 1821598418 | Alyan Ali, M.d., Inc. | Internal Medicine | 20103 Lake Chabot Rd, Castro Valley, CA 94546 | 2018-02-20 |
| 1508374489 | David C Bonovich Md | Psychiatry & Neurology | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2018-01-13 |
| 1922511278 | Lisa Gaye Quan | Registered Nurse | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2017-11-08 |
| 1114439593 | David Paul Rathmann | Speech-Language Pathologist | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2017-10-25 |
| 1205378668 | Jacqueline Margolese | Nurse Practitioner | 20103 Lake Chabot Rd, Castro Valley, CA 94546-5305 | 2016-11-15 |
| 1386098309 | Travis Sunlum Lee | Internal Medicine | 20103 Lake Chabot Rd, Castro Valley, CA 94546 | 2016-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861991234 | For Your Eyes Only Ophthalmic Medical Corp. | Optometrist | 2687 Castro Valley Blvd., Castro Valley, CA 94546 | 2018-02-12 |
| 1821536954 | Webster Surgery Center, Lp | Clinic/Center | 20998 Redwood Dr, Castro Valley, CA 94546 | 2017-02-09 |
| 1639506215 | Jennifer Lee | Pharmacist | 20629 Redwood Road, Castro Valley, CA 94546 | 2013-09-27 |
| 1679860506 | Lauren Nicole Hill | Counselor | 20212 Redwood Rd Ste 104, Castro Valley, CA 94546 | 2011-06-29 |
| 1326330952 | Jeannette Villalobos | Counselor | 5248 Crane Avenue, Castro Valley, CA 94546 | 2011-05-16 |
| 1780992560 | Cherie Christine-vivona Clark | Physician Assistant | Eden Emergency Department, 20103 Lake Chabot Road, Castro Valley, CA 94546 | 2010-09-15 |
| 1518287218 | Rite Aid Incorporation | Community/Behavioral Health | 3548 Castro Valley Blv, Castro Valley, CA 94546 | 2010-06-03 |
| 1770719940 | Kristina Marie Sotto | Occupational Therapist | 20259 Lake Chabot Road, Castro Valley, CA 94546 | 2009-06-02 |
| 1861664203 | Bannanje R Nayak | Physical Medicine & Rehabilitation | 19830 Lake Chabot Road, Ste C, Castro Valley, CA 94546 | 2008-03-26 |
| 1205030202 | Yvonne Marie Jones | Social Worker | 2055 Fairmont Dr., San Leandro, CA 94546 | 2007-06-13 |
| Find all providers in zip 94546 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1053910273 | Onsite Phlebotomy Solutions | Clinical Medical Laboratory | 1040 S Mount Vernon Ave # G-276, Colton, CA 92324-4228 | 2020-10-19 |
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| 1518565514 | Clarity Mobile Venture LLC | Clinical Medical Laboratory | 651 World Way, Los Angeles, CA 90045-5815 | 2020-10-12 |
| 1083212351 | Telomere Diagnostics, Inc. | Clinical Medical Laboratory | 2688 Middlefield Rd Ste A, Redwood City, CA 94063-3483 | 2020-10-09 |
| 1588261127 | Safesite LLC | Clinical Medical Laboratory | 26660 Agoura Rd, Calabasas, CA 91302-1954 | 2020-10-07 |
| 1366049447 | Sts Lab 1 LLC | Clinical Medical Laboratory | 2302 Trade Zone Blvd Rm 100, San Jose, CA 95131-1819 | 2020-10-02 |
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| City | CASTRO VALLEY |
| Zip Code | 94546 |
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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.