Glen William Petersen (NPI# 1467495986, PAC ID# 4183520802) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CRITICAL CARE (INTENSIVISTS).
| Nation Provider ID (NPI) | 1467495986 |
| PAC ID by PECOS | 4183520802 |
| Professional Enrollment ID | I20040527000788 |
| Full Name | Glen William Petersen |
| Organization Legal Name | EAST BAY REGIONAL CRITICAL CARE AND PULMONARY MEDICINE INC |
| Address |
411 30th St Fl 3 Oakland CA 94609-3310 |
| Phone Number | 5104656800 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE |
| Graduation Year | 1973 |
| Primary Specialty | CRITICAL CARE (INTENSIVISTS) |
| Secondary Specialties | PULMONARY DISEASE |
| Group Practice PAC ID | 6507857828 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050305 | ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP |
| 050043 | ALTA BATES SUMMIT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 411 30th St, Fl 3, Oakland, CA 94609-3310 | 5104656800 | EAST BAY REGIONAL CRITICAL CARE AND PULMONARY MEDICINE INC |
| Organization Legal Name | EAST BAY REGIONAL CRITICAL CARE AND PULMONARY MEDICINE INC |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hemal J Parekh | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| James Edward Mcfeely | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Leena S Jalota | Internal Medicine | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Fredric N Herskowitz | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Kristina M Kury | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 13847 E 14th St, Suite 216, San Leandro, CA 94578-2626 |
| Barry Roy Horn | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Andrea L Green | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 13847 E 14th St, Suite 216, San Leandro, CA 94578-2626 |
| Justin P Dumouchel | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 13847 E 14th St, Suite 216, San Leandro, CA 94578-2626 |
| Yazen Beddawi | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Neha K Ahuja | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Street Address |
411 30TH ST FL 3 |
| City | OAKLAND |
| State | CA |
| Zip | 94609-3310 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hemal J Parekh | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| James Edward Mcfeely | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Leena S Jalota | Internal Medicine | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Clifford R Melton | Urology | 411 30th St, Suite 520, Oakland, CA 94609-3303 | |
| Fredric N Herskowitz | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Barry Roy Horn | Pulmonary Disease | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Wade R Cartwright | Otolaryngology | 411 30th St, Suite 401, Oakland, CA 94609-3303 | |
| Yazen Beddawi | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Neha K Ahuja | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Valentine T Ifeacho | Critical Care (intensivists) | East Bay Regional Critical Care and Pulmonary Medicine Inc | 411 30th St, Fl 3, Oakland, CA 94609-3310 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Virginia A Frederick | Chiropractic | 6434 Telegraph Ave, Oakland, CA 94609-1112 | |
| Douglas B Ross | Chiropractic | 6434 Telegraph Ave, Oakland, CA 94609-1112 | |
| Andrea L Long | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Richard W Burg | Chiropractic | 6330 Telegraph Ave, Oakland, CA 94609-1329 | |
| Lisa Gibson | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Dawn J Loretz | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Kathryn Rittenberg | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Nancy Kathleen Bryan | Physical Therapy | Sports and Orthopedic Specialists | 6300 Telegraph Ave, Oakland, CA 94609-1329 |
| Chelsea S Landolin | Nurse Practitioner | Bonita House, Inc. | 6333 Telegraph Ave, Suite 102, Oakland, CA 94609-1359 |
| Manton S Hurd | Nurse Practitioner | Bonita House, Inc. | 6333 Telegraph Ave, Suite 102, Oakland, CA 94609-1359 |
| Find all physicians in zip 94609 | |||
| City | OAKLAND |
| Zip Code | 94609 |
| Specialty | CRITICAL CARE (INTENSIVISTS) |
| City + Specialty | OAKLAND + CRITICAL CARE (INTENSIVISTS) |
Please comment or provide details below to improve the information on Glen William Petersen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.