ALTA EAST BAY PATHOLOGY, INC. (NPI# 1003878240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003878240 |
| Entity Type | Organization |
| Organization Name | ALTA EAST BAY PATHOLOGY, INC. |
| Practice Address |
2450 Ashby Ave Berkeley CA 94705-2067 |
| Mailing Address |
Po Box 10076 Van Nuys CA 91410-0076 |
| Practice Telephone | 5108696567 |
| Mailing Telephone | 8055788300 |
| Mailing Fax Number | 8055788950 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2008-03-07 |
| Authorized Official Name | ANNETTE SHAIEB (PRESIDENT) |
| Authorized Official Telephone | 5108696567 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0022700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578514196 | Alta East Bay Pathology, Inc. | Clinical Medical Laboratory | 3100 Summit St, Oakland, CA 94609-3410 | 2006-05-16 |
| 1316909559 | Alta East Bay Pathology, Inc. | Clinical Medical Laboratory | 350 Hawthorne Ave, Oakland, CA 94609-3108 | 2006-04-04 |
| Street Address |
2450 ASHBY AVE |
| City | BERKELEY |
| State | CA |
| Zip Code | 94705-2067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366447369 | Henry Hinchung Tan | Internal Medicine | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2005-06-16 |
| 1154940286 | Kassandra Marie Donnels | Advanced Practice Midwife | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2020-04-09 |
| 1881221646 | Stephanie Miller | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2020-03-23 |
| 1962966689 | Samantha Ann Misslbeck | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2019-01-27 |
| 1851898837 | Obianauju Vivian Ogu | Registered Nurse | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2018-04-06 |
| 1033649579 | Robert Michael Roth | Emergency Medicine | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2017-06-18 |
| 1306294962 | Anh Dang | General Acute Care Hospital | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2016-05-24 |
| 1639523004 | Sutter Bay Hospitals | Clinical Medical Laboratory | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2016-04-21 |
| 1316312648 | Zain Daniel Bartlett Morin | Pharmacist | 2450 Ashby Ave, Berkeley, CA 94705-2067 | 2015-12-11 |
| 1841663804 | Ilana Rose Pearlman | Advanced Practice Midwife | 2450 Ashby Ave, Rm. 3040, Berkeley, CA 94705-2067 | 2015-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882956 | Diane Lomas Wyatt | Marriage & Family Therapist | 2340 Ward St. Ste 104, Berkeley, CA 94705 | 2020-02-12 |
| 1700371275 | Icecreamwala Dermatology Inc | Dermatology | 2435 Webster St Ste 101, Berkeley, CA 94705 | 2018-06-27 |
| 1396253803 | David R Shaddock | Marriage & Family Therapist | 3030 Ashby Avenue, # 105, Berkeley, CA 94705 | 2018-01-18 |
| 1821504432 | Allegra Tringali | Physical Therapist | 2450 Ashby Ave Fl 6, Berkeley, CA 94705 | 2017-12-19 |
| 1659898740 | Hunter Brown | Student in an Organized Health Care Education/Training Program | Wright Institute Clinical Services 1918 University Ave, Suite 2b, Berkeley, CA 94705 | 2017-08-29 |
| 1588014534 | Heather Valdez | Social Worker | 2185 Ashby Ave, Berkeley, CA 94705 | 2016-06-20 |
| 1215350145 | S.e.e.d.s. (social and Emotional Education Development and Support) | Community/Behavioral Health | 3120 Telegraph Avenue Ste 9, Berkeley, CA 94705 | 2014-01-29 |
| 1144580960 | Benjamin Tucker | Counselor | 2625 Alcatraz Ave Ste 609, Berkeley, CA 94705 | 2012-05-26 |
| 1881966141 | Jennifer Cowherd | Behavioral Analyst | 2201 Woolsey St, Berkeley, CA 94705 | 2012-02-02 |
| 1518255892 | Erika D Huguenard | Counselor | 2811a College Avenue, Berkeley, CA 94705 | 2011-07-20 |
| Find all providers in zip 94705 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
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| 1093277956 | Shajia Rahman Ansari | Pathology | 38558 Vancouver Cmn, Fremont, CA 94536-4056 | 2019-04-01 |
| 1831655158 | Rana Richeh | Pathology | 12 Spectrum Pointe Dr, Lake Forest, CA 92630-2242 | 2019-02-11 |
| 1710457510 | University of California Sfgh Medical Group | Pathology | 1001 Potrero Ave Rm 2m14, San Francisco, CA 94110-3518 | 2018-12-05 |
| 1770053233 | Samuel Jason Guzman | Pathology | 10026 Karmont Ave, South Gate, CA 90280-5417 | 2018-11-27 |
| 1144799750 | Penguin Medical Group, Inc | Pathology | 11 W Del Mar Blvd Ste 201, Pasadena, CA 91105-2593 | 2018-11-13 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1972080752 | Boris Shlopov Md Pathology Medical Corporation | Pathology | 800 S Main, Corona, CA 92882 | 2018-07-24 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
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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.