EAST BAY VASCULAR MEDICAL GROUP (NPI# 1619072923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619072923 |
| Entity Type | Organization |
| Organization Name | EAST BAY VASCULAR MEDICAL GROUP |
| Practice Address |
130 La Casa Via Ste 201 Bldg 1 Walnut Creek CA 94598 |
| Practice Telephone | 9259325313 |
| Mailing Telephone | 9259325313 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2008-01-30 |
| Authorized Official Name | NANCI CARTER WEBB (PRACTICE MANAGER) |
| Authorized Official Telephone | 5108326131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861503351 | East Bay Vascular Medical Group | Surgery | 365 Hawthorne Ave, Suite 103, Oakland, CA 94609-3107 | 2006-08-31 |
| Street Address |
130 LA CASA VIA STE 201 BLDG 1 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023010030 | Nathan David Schultz | Allergy & Immunology | 130 La Casa Via, Bldg 2, Ste 209, Walnut Creek, CA 94598-3045 | 2005-08-10 |
| 1760856579 | Bay Area Surgical Specialists Inc A Medical Corporation | Orthopaedic Surgery | 130 La Casa Via, Bldg 3-111, Walnut Creek, CA 94598-3045 | 2015-11-17 |
| 1023442167 | Angela Christian | Nurse Practitioner | 130 La Casa Via, Suite 209, Walnut Creek, CA 94598-3045 | 2013-08-26 |
| 1083956213 | Irene Jia-shin Lo | Surgery | 130 La Casa Via, Building 3, Suite 211, Walnut Creek, CA 94598-3045 | 2013-03-26 |
| 1952696684 | Emily Rebecca Silver Brama | Nurse Practitioner | 130 La Casa Via, #209, Walnut Creek, CA 94598 | 2011-06-10 |
| 1346542743 | Nourollah B. Ghorbani,m.d.inc. | Clinic/Center | 130 La Casa Via, Suite 102, Walnut Creek, CA 94598-3045 | 2010-11-17 |
| 1134364789 | Mark David Levine, Md Walnut Creek Professional Corporation | Psychiatry & Neurology | 130 La Casa Via, Suite 2-208, Walnut Creek, CA 94598-3045 | 2008-12-11 |
| 1881849404 | Mark David Levinemd, Walnut Creek, PC | Psychiatry & Neurology | 130 La Casa Via, Suite: 2-208, Walnut Creek, CA 94598-3045 | 2008-11-24 |
| 1467611244 | Arash Mohebati | Surgery | 130 La Casa Via, Bldg 3, Suite 211, Walnut Creek, CA 94598-3045 | 2008-06-05 |
| 1033386503 | Manjari Nathan | Internal Medicine | 130 La Casa Via, Bldg.#2, Suite 208, Walnut Creek, CA 94598-3045 | 2008-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 |
|---|---|---|---|---|
| 1336209717 | Hin Nang Wong | Surgery | 130 La Casa Via Ste 212 Bldg 3, Walnut Creek, CA 94598-3041 | 2006-12-08 |
| 1639268758 | Rishyur K Jothi | Surgery | 108 Via Mantilla, Walnut Creek, CA 94598-3524 | 2006-10-12 |
| 1508803172 | Muir Surgical Medical Group Inc | Surgery | 1515 Ygnacio Valley Rd, # A, Walnut Creek, CA 94598 | 2006-06-01 |
| 1104978329 | Charles F. Rieder | Surgery | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2007-01-17 |
| 1144308222 | Charles W. Bouch | Surgery | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1710065826 | Sung S. Cho | Surgery | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1083792188 | Kara L. Riley-paull | Surgery | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1609987924 | Keshav K Pandurangi | Surgery | 2637 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881213817 | Robert Morton Carroll X | Surgery | 2241 Century Hl, Los Angeles, CA 90067-3506 | 2020-04-09 |
| 1992341895 | Surgicalist of Ca PC | Surgery | 3300 E South St Ste 301a, Lakewood, CA 90805-4549 | 2019-11-26 |
| 1528600558 | Kevin M Casey Md Apmc | Surgery | 1919 State St # 204-206, Santa Barbara, CA 93101-2430 | 2019-10-10 |
| 1487117594 | John Nastasi | Surgery | 100 W Valencia Mesa Dr # 211, Fullerton, CA 92835-3768 | 2019-04-08 |
| 1225508385 | Jay Labourene | Surgery | 1550 G Tiburon Blvd, Tiburon, CA 94920-2531 | 2018-12-03 |
| 1467922120 | Paul Bressman Md Inc | Surgery | 1493 S Crest Dr, Los Angeles, CA 90035-3339 | 2018-11-26 |
| 1437638517 | Thousand Oaks Vein Clinic PC | Surgery | 225 N Moorpark Rd Ste C, Thousand Oaks, CA 91360-4320 | 2018-08-09 |
| 1881186377 | Lavs Access Center Inc. | Surgery | 620 W Beverly Blvd Ste B, Montebello, CA 90640-3624 | 2018-05-31 |
| 1841789328 | Sunil Rayan, M.d., Inc. | Surgery | 320 Santa Fe Dr Ste 212, Encinitas, CA 92024-5139 | 2018-05-09 |
| 1245739820 | Northridge Vascular Center A Professional Medical Corporation | Surgery | 19331 Business Center Dr Ste 102, Northridge, CA 91324-3533 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
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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.