EAST BAY RETINA CONSULTANTS A MEDICAL GROUP, INC. (NPI# 1124319959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124319959 |
| Entity Type | Organization |
| Organization Name | EAST BAY RETINA CONSULTANTS A MEDICAL GROUP, INC. |
| Other Organization Name | EAST BAY RETINA CONSULTANTS, INC. |
| Practice Address |
1401 Willow Pass Rd Suite 120 Concord CA 94520-7982 |
| Mailing Address |
3300 Telegraph Ave Oakland CA 94609-3028 |
| Practice Telephone | 9256801600 |
| Practice Fax Number | 9256801602 |
| Mailing Telephone | 5104441600 |
| Mailing Fax Number | 5104441828 |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2016-02-29 |
| Authorized Official Name | SOON T LEE (CORPORATE VICE PRESIDENT) |
| Authorized Official Telephone | 5104441600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | A44312 | CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| East Bay Retina Consultants, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790965341 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 3300 Telegraph Ave., Oakland, CA 94609-3028 | 2007-11-13 |
| 1679855076 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 5924 Stoneridge Dr, Suite 201, Pleasanton, CA 94588-2887 | 2011-09-13 |
| 1578509667 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 5401 Norris Canyon Rd, Suite 200, San Ramon, CA 94583-5409 | 2006-06-20 |
| 1487690574 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 1860 Mowry Ave, Suite 308, Fremont, CA 94538-1730 | 2006-06-20 |
| 1326031907 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 3300 Webster St, Suite 1110, Oakland, CA 94609-3117 | 2005-08-29 |
| Street Address |
1401 WILLOW PASS RD SUITE 120 |
| City | CONCORD |
| State | CA |
| Zip Code | 94520-7982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023015252 | Medical Insights Diagnostic | Specialist | 1401 Willow Pass Rd, Suite 110, Concord, CA 94520-7982 | 2005-07-01 |
| 1114043296 | John R Horn | Specialist | 1401 Willow Pass Rd, Suite 110, Concord, CA 94520-7982 | 2007-03-21 |
| 1871601674 | Marshall Morgan | Specialist | 1401 Willow Pass Rd, Suite 110, Concord, CA 94520-7982 | 2006-08-29 |
| 1760411201 | Arthur Gronner | Specialist | 1401 Willow Pass Rd, Ste 110, Concord, CA 94520-7982 | 2006-06-30 |
| 1912941469 | Virgil L Williams | Specialist | 1401 Willow Pass Rd, Ste 110, Concord, CA 94520-7982 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275130163 | Jessica E. Hiers | Audiologist | 2280 Diamnond Blvd, Suite 520, Concord, CA 94520 | 2020-10-05 |
| 1538712690 | Melody Louise Todd | Student in an Organized Health Care Education/Training Program | 2112 Willow Pass Rd., Suite 500, Concord, CA 94520 | 2019-07-18 |
| 1497319446 | Nately Rose | Social Worker | Contra Costa County Behavioral Health, 2425 Bisso Lane, Ste 200, Concord, CA 94520 | 2019-04-25 |
| 1609331412 | Darien Mccollins Jr. | Case Manager/Care Coordinator | 2380 Salvio Street Stu 200, Concord, CA 94520 | 2019-02-06 |
| 1972072122 | Rocio Flores Neale | Physician Assistant | 2415 High School Avenue, Suite 800, Concord, CA 94520 | 2018-11-16 |
| 1386129138 | Vanessa Segovia | Registered Nurse | 2500 Bates Ave., Suite B, Concord, CA 94520 | 2018-09-27 |
| 1417442278 | Raquel Jihan Chiasson | Social Worker | 2900 Avon Avenue, Concord, CA 94520 | 2018-06-25 |
| 1184118143 | Angela Navarro | Behavioral Analyst | 1844 Overhill Rd, Concord, CA 94520 | 2018-06-21 |
| 1811498678 | Sherry Currie-proctor | Case Manager/Care Coordinator | 2380 Salvio Street, Concord, CA 94520 | 2018-02-26 |
| 1770082547 | Donna Christianson | Marriage & Family Therapist | 2401 Stanwell Drive, Suite 460, Office #2, Concord, CA 94520 | 2018-02-07 |
| Find all providers in zip 94520 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518207794 | Lexington Eye Associates - Optical | Ophthalmology | 300 Baker Ave Ste 210, Concord, MA 01742 | 2013-02-25 |
| 1578707261 | Shaun Bradley Robinson | Ophthalmology | 201 Le Phillip Ct Ne, Concord, NC 28025-2900 | 2009-04-24 |
| 1811105794 | Harvey H Slansky | Ophthalmology | 1772 Wedgewood Cmn, Concord, MA 01742-2898 | 2007-05-21 |
| 1538293279 | Jason Paul Handler | Ophthalmology | 201 Lephillip Court, Ne, Concord, NC 28025-2900 | 2007-03-15 |
| 1619016052 | Arun Prasad | Ophthalmology | 3330 Clayton Rd, Suite A, Concord, CA 94519-2838 | 2007-02-05 |
| 1164502076 | David Alan Weinberg | Ophthalmology | 248 Pleasant St Ste 1600, Concord Eye Care, Concord, NH 03301-2588 | 2006-10-16 |
| 1770689085 | William P Boger | Ophthalmology | 9 Acre Centre, Lexington Eye Associates, Concord, MA 01742 | 2006-09-15 |
| 1295839918 | Buhilda Mcgriff | Ophthalmology | 1025 Vinehaven Dr Ne, Concord, NC 28025-2439 | 2006-09-12 |
| 1417969650 | Viet Huy Ho | Ophthalmology | 2299 Bacon St Ste 11, Concord, CA 94520 | 2006-08-13 |
| 1497784664 | Northeast Eye Center Pa | Ophthalmology | 33 Lake Concord Ne, Concord, NC 28025-3015 | 2006-07-01 |
| Find all providers in CONCORD | ||||
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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.