EAST BAY NEUROSURGERY AND SPINE, A MEDICAL CORPORATION (NPI# 1104895846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104895846 |
| Entity Type | Organization |
| Organization Name | EAST BAY NEUROSURGERY AND SPINE, A MEDICAL CORPORATION |
| Practice Address |
2999 Regent St Suite 715 Berkeley CA 94705-2190 |
| Practice Telephone | 5108418700 |
| Mailing Telephone | 5108418700 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2010-10-05 |
| Authorized Official Name | DR. GORDON TANG (PRESIDENT) |
| Authorized Official Telephone | 5108418700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | G83573 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2999 REGENT ST SUITE 715 |
| City | BERKELEY |
| State | CA |
| Zip Code | 94705-2190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962487421 | Shahin M Javaheri | Plastic Surgery | 2999 Regent St, Number 626, Berkeley, CA 94705-2146 | 2005-12-07 |
| 1326585449 | Golden Gate Urology Inc | Non-Pharmacy Dispensing Site | 2999 Regent St, Suite 612 & 626, Berkeley, CA 94705-2190 | 2017-01-26 |
| 1639553217 | Susan Su | Optometrist | 2999 Regent St, Suite 425, Berkeley, CA 94705-2190 | 2015-07-14 |
| 1487908802 | Robert J. Stallone M.d., Inc. | Surgery | 2999 Regent St, Suite 622, Berkeley, CA 94705-2190 | 2012-11-07 |
| 1205115128 | Jaikrishna Balkisson,md & Laurie E. Schweitzer, Md | Specialist | 2999 Regent St, 300, Berkeley, CA 94705-2190 | 2011-08-09 |
| 1407150139 | Ryan Lawrence Horn, D.d.s. | Dentist | 2999 Regent St, Suite #403, Berkeley, CA 94705-2190 | 2011-01-10 |
| 1841593472 | Elizabeth Slass Lee A Medical Corporation | Plastic Surgery | 2999 Regent St, Suite 401, Berkeley, CA 94705-2190 | 2010-12-21 |
| 1215191002 | Unilab Corporation | Clinical Medical Laboratory | 2999 Regent St, Suite 101, Berkeley, CA 94705-2146 | 2008-07-11 |
| 1962678979 | Beth Schneider | Acupuncturist | 2999 Regent St, Ste 225, Berkeley, CA 94705-2146 | 2008-04-30 |
| 1023283025 | Williamtennantdds/williamgiannidds | Dentist | 2999 Regent St, Suite 714, Berkeley, CA 94705-2146 | 2008-04-30 |
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| 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 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740237221 | Robert A. Fink, Md, Facs, PC | Neurological Surgery | 2500 Milvia St, Suite 222, Berkeley, CA 94704-2636 | 2006-05-28 |
| 1063481588 | Gordon Tang | Neurological Surgery | 2999 Regent St, Suite 715, Berkeley, CA 94705-2190 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144477 | Faculty Physicians and Surgeons of Llusm | Neurological Surgery | 35400 Bob Hope Dr Ste 110, Rancho Mirage, CA 92270-1772 | 2020-11-04 |
| 1013524123 | Hubert Tsun-yin Lee | Neurological Surgery | 1201 Welch Road, Stanford, CA 94305-5327 | 2020-09-24 |
| 1811500267 | Chaparral Medical Group, Inc. | Neurological Surgery | 9120 Haven Ave Ste 201, Rancho Cucamonga, CA 91730-5413 | 2020-08-26 |
| 1982259461 | Mauricio Mandel Brigido | Neurological Surgery | 300 Pasteur Dr # R281, Stanford, CA 94305-2200 | 2019-08-01 |
| 1538713227 | Sylvain Palmer Md Inc | Neurological Surgery | 26732 Crown Valley Pkwy Ste 541, Mission Viejo, CA 92691-6376 | 2019-07-31 |
| 1851945877 | X.sean Xin, Do Inc. | Neurological Surgery | 7230 Med Ctr Dr Ste 600, West Hills, CA 91307-4017 | 2019-07-29 |
| 1154974525 | Jan M. Eckermann, Md Inc. | Neurological Surgery | 1617 W Cliff Dr, Ste 203, Newport Beach, CA 92660 | 2019-07-24 |
| 1598317711 | Newport Beach Neurosurgical Institute | Neurological Surgery | 1501 Superior Ave Ste 214b, Newport Beach, CA 92663-3600 | 2019-07-09 |
| 1609438761 | Py26 Neurosurgery, PC | Neurological Surgery | 120 S Spalding Dr Ste 305, Beverly Hills, CA 90212-1800 | 2019-06-28 |
| 1679133664 | Sequoia Neurosurgery, Inc. | Neurological Surgery | 306 N Conyer St Ste A, Visalia, CA 93291-4704 | 2019-06-20 |
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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.