PONTINE INCORPORATED (NPI# 1053757609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053757609 |
| Entity Type | Organization |
| Organization Name | PONTINE INCORPORATED |
| Practice Address |
1900 Harmon St Berkeley CA 94703-2725 |
| Practice Telephone | 5102259090 |
| Mailing Telephone | 5102259090 |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-05-22 |
| Authorized Official Name | DR. YUSUF HAROON AHMAD (PRESIDENT) |
| Authorized Official Telephone | 5102259090 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
A116785 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL LICENSE | A116785 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1006 Nut Tree Rd, Vacaville, CA 956874100 | 2093399022 | 2093399033 |
| Street Address |
1900 HARMON ST |
| City | BERKELEY |
| State | CA |
| Zip Code | 94703-2725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811553621 | Brittney Jerrilena Monique Garrett | Behavioral Analyst | 1901 Stuart St, Berkeley, CA 94703 | 2019-05-16 |
| 1740762178 | Maryam Jabbari Amiri | Student in an Organized Health Care Education/Training Program | 3075 Adeline Street, Suite 120, Berkeley, CA 94703 | 2018-09-01 |
| 1619427549 | Sigal Gafni | Occupational Therapist | 1622 Parker St. Apt. 1, Berkeley, CA 94703 | 2016-10-04 |
| 1750741138 | Ane Becker | Community Health Worker | 2026 Woolsey St, Berkeley, CA 94703 | 2016-02-29 |
| 1245697135 | Sara Dinome Teel Vargas | Chiropractor | 3286 Adeline St., Suite 9, Berkeley, CA 94703 | 2016-01-22 |
| 1083081608 | Olivia Debree | Nurse Practitioner | 3075 Adeline Street, Suite 280, Lifelong Medical Care, Ashby Health Center, Berkeley, CA 94703 | 2015-08-31 |
| 1962885988 | Caro Grosvenor | Marriage & Family Therapist | 1511 Ada Street, Berkeley, CA 94703 | 2015-07-08 |
| 1619378452 | Myles Malone | Counselor | 2413 Jefferson Ave., Berkeley, CA 94703 | 2014-09-11 |
| 1013340223 | Denise Daniel | Acupuncturist | 6222 La Salle Ave Suite B, Oakland, CA 94703 | 2013-08-12 |
| 1104126200 | Iramis Kouromenos | Dental Hygienist | 1721 University Ave Apt#209, Berkeley, CA 94703 | 2010-10-25 |
| Find all providers in zip 94703 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336442078 | Michael Nian Peng Shi, L.ac., Ph.d. | Clinic/Center | 1919 Addison St, Suite 101, Berkeley, CA 94704-1141 | 2010-12-20 |
| 1205159258 | Allergy & Immunology Clinic of East Bay | Clinic/Center | 2320 Woolsey St, Ste 314, Berkeley, CA 94705-1973 | 2010-03-04 |
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| Find all providers with the same taxonomy | ||||
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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.