THE SURGERY CENTER OF ALTA BATES SUMMIT MEDICAL CENTER, LLC (NPI# 1245327493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245327493 |
| Entity Type | Organization |
| Organization Name | THE SURGERY CENTER OF ALTA BATES SUMMIT MEDICAL CENTER, LLC |
| Practice Address |
3875 Telegraph Ave Oakland CA 94609-2428 |
| Practice Telephone | 5105472244 |
| Mailing Telephone | 5105472244 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JUDITH RICH (ADMINISTRATOR) |
| Authorized Official Telephone | 5105472244 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE CROSS | 551028 | 01 |
| CA | BLUE SHIELD | ZZZH0117Z | 01 |
| Street Address |
3875 TELEGRAPH AVE |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-2428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083642284 | John Markwith Stanec | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-06-28 |
| 1720204209 | Thomas M. Armbruster | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2007-04-17 |
| 1023191939 | Richard Glaser | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-10-23 |
| 1801984067 | Larry W Fusch | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-10-11 |
| 1225121189 | Glen Gormezano | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-10-02 |
| 1447350566 | Allan Horn | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-09-25 |
| 1609882133 | Andrew Moon | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-08-01 |
| 1053326850 | Brian Hite | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-07-30 |
| 1437178563 | Ambulatory Consultants Medical Group Inc | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-07-19 |
| 1871511105 | Laura E. Woo | Anesthesiology | 3875 Telegraph Ave, Oakland, CA 94609-2428 | 2006-07-17 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972114171 | Surgery Center of Oakland Lp | Clinic/Center | 80 Grand Ave Ste M-1, Oakland, CA 94612-3725 | 2020-08-11 |
| 1881765964 | Bay Surgery Center Lp | Clinic/Center | 6633 Telegraph Ave, Suite B, Oakland, CA 94609-1115 | 2006-11-13 |
| 1760923445 | Dialysis Access Center A Medical Corporation | Clinic/Center | 3012 Summit St, D Wing, Oakland, CA 94609-3480 | 2017-03-15 |
| 1518374354 | Garani S. Nadaraja, A Professional Corporation | Clinic/Center | 744 52nd St, Multispecialty Clinic, Oakland, CA 94609-1810 | 2014-07-14 |
| 1518106996 | East Bay Special Surgery LLC | Clinic/Center | 80 Grand Ave, Suite 100, Oakland, CA 94612-3725 | 2009-02-09 |
| 1447301593 | 481 Asc Project LLC | Clinic/Center | 481 30th St, Oakland, CA 94609-3209 | 2007-01-16 |
| 1972677755 | Dialysis Access Center, Inc | Clinic/Center | 3012 Summit St, D Wing, Oakland, CA 94609-3480 | 2006-11-20 |
| 1053496240 | Oakland Ca Endoscopy Asc Lp | Clinic/Center | 300 Frank Ogawa Plaza, Suite 135, Oakland, CA 94612 | 2006-10-26 |
| 1194835686 | East Bay Endosurgery Center Inc | Clinic/Center | 300 Frank Ogawa Plaza, Suite 135, Oakland, CA 94612 | 2006-08-30 |
| 1366485385 | Webster Surgery Center, Lp | Clinic/Center | 80 Grand Ave, Suite 250, Oakland, CA 94612-3725 | 2006-06-14 |
| Find all providers in OAKLAND | ||||
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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.