COLLIN A MBANUGO (NPI# 1134271471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134271471 |
| Entity Type | Individual |
| Full Name | COLLIN A MBANUGO |
| Credential | M.D. |
| Practice Address |
3300 Webster St Suite 900 Oakland CA 94609-3117 |
| Practice Telephone | 5102729610 |
| Practice Fax Number | 5102729612 |
| Mailing Telephone | 5102729610 |
| Mailing Fax Number | 5102729612 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2016-01-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 00C411000 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C411000 | 05 |
| Street Address |
3300 WEBSTER ST SUITE 900 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073517603 | James K. Mooney | Specialist | 3300 Webster St, Ste 710, Oakland, CA 94609-3117 | 2005-06-10 |
| 1174970461 | Malboubi Dental Corporation | Dentist | 3300 Webster St, Suite 905, Oakland, CA 94609-3117 | 2016-05-17 |
| 1245607456 | Hill Health Inc A Medical Corporation | Family Medicine | 3300 Webster St, Oakland, CA 94609-3117 | 2015-08-24 |
| 1669879714 | Catherine Logan Maier | Registered Nurse | 3300 Webster St, Suite 1200, Oakland, CA 94609-3117 | 2014-12-03 |
| 1124420658 | Brianna Nicole Cosentino | Physical Therapist | 3300 Webster St, 1201, Oakland, CA 94609-3117 | 2014-09-16 |
| 1477966919 | Jessica Tice | Physical Therapist | 3300 Webster St, 703, Oakland, CA 94609-3117 | 2014-06-03 |
| 1205174505 | Kelly Lee Wong | Internal Medicine | 3300 Webster St, 1000, Oakland, CA 94609-3117 | 2013-01-21 |
| 1770885741 | Rachel L Kay | Nurse Practitioner | 3300 Webster St, Suite 304, Oakland, CA 94609-3117 | 2010-11-24 |
| 1306146568 | Carolyn Jacobs Bernstein | Nurse Practitioner | 3300 Webster St, Oakland, CA 94609-3117 | 2010-10-21 |
| 1528378460 | John Alexander Gillean | Psychiatry & Neurology | 3300 Webster St, Suite 402, Oakland, CA 94609-3117 | 2010-10-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344321 | Sadeghi Medical Corporation | Surgery | 3871 Piedmont Ave # 105, Oakland, CA 94611-5378 | 2020-10-21 |
| 1598316143 | Heritage Laparoscopy Acute Care Surgery PC | Surgery | 9 Post Rd Ste M7, Oakland, NJ 07436-1615 | 2019-09-25 |
| 1699164137 | Thomas Michael Slemmer | Surgery | 6559 Farallon Way, Oakland, CA 94611-1201 | 2015-01-22 |
| 1336554708 | Benjamin Patrick Sopczynski | Surgery | 365 Hawthorne Ave Ste 101, Oakland, CA 94609-3115 | 2014-06-24 |
| 1922325695 | Leslie Wong | Surgery | 3600 Broadway Fl 3, Oakland, CA 94611-5730 | 2010-04-21 |
| 1649507146 | Charles William Fedde | Surgery | 410 Sam Snead Cir, Oakland, MD 21550-5507 | 2009-11-04 |
| 1619203866 | Pooyan B Sadeghi | Surgery | 39 Montell St, Oakland, CA 94611-4923 | 2009-10-22 |
| 1659530822 | Kelley I-kai Chuang | Surgery | 1411 E 31st St # 22134, Oakland, CA 94602-1018 | 2008-06-03 |
| 1396845384 | Charles A Walch | Surgery | 255 North 4th Street, Suite 2, Oakland, MD 21550-1395 | 2006-09-22 |
| 1235171307 | Eileen T. Consorti | Surgery | 350 30th St Ste 411, Oakland, CA 94609 | 2006-06-12 |
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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.