EAST BAY RETINA CONSULTANTS A MEDICAL GROUP, INC. (NPI# 1679855076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679855076 |
| Entity Type | Organization |
| Organization Name | EAST BAY RETINA CONSULTANTS A MEDICAL GROUP, INC. |
| Other Organization Name | EAST BAY RETINA CONSULTANTS, INC. |
| Practice Address |
5924 Stoneridge Dr Suite 201 Pleasanton CA 94588-2887 |
| Mailing Address |
3300 Telegraph Ave Oakland CA 94609-3028 |
| Practice Telephone | 9252248777 |
| Practice Fax Number | 9252248779 |
| Mailing Telephone | 5104441600 |
| Mailing Fax Number | 5104445117 |
| Enumeration Date | 2011-09-13 |
| 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 |
| 1124319959 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 1401 Willow Pass Rd, Suite 120, Concord, CA 94520-7982 | 2011-04-27 |
| 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 |
5924 STONERIDGE DR SUITE 201 |
| City | PLEASANTON |
| State | CA |
| Zip Code | 94588-2887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124082359 | Lucille B. Andersen | Orthopaedic Surgery | 5924 Stoneridge Dr, Suite 103, Pleasanton, CA 94588-2887 | 2006-04-14 |
| 1366813610 | Eun-ju Park | Acupuncturist | 5924 Stoneridge Dr, Suite 204a, Pleasanton, CA 94588-2887 | 2015-10-13 |
| 1407287592 | Accura Imaging, Inc | Radiologic Technologist | 5924 Stoneridge Dr, Suite 205, Pleasanton, CA 94588-2887 | 2013-11-27 |
| 1619318391 | Summit Surgery Center LLC | Clinic/Center | 5924 Stoneridge Dr, 206, Pleasanton, CA 94588-2887 | 2013-07-10 |
| 1235575051 | Andersen Orthopedics, A Professional Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr, Suite 103, Pleasanton, CA 94588-2887 | 2013-05-20 |
| 1194094144 | Marta Baird | Dentist | 5924 Stoneridge Dr, Suite 203, Pleasanton, CA 94588-2887 | 2011-12-20 |
| 1164708582 | Navin Mallavaram, M.d., Inc. | Pain Medicine | 5924 Stoneridge Dr, Suite 206, Pleasanton, CA 94588-2887 | 2011-10-31 |
| 1801192646 | Breastlink Medical Group Inc | Chiropractor | 5924 Stoneridge Dr, Suite 108, Pleasanton, CA 94588-2887 | 2011-01-26 |
| 1255633707 | Pain Medicine Consultants, Inc. | Durable Medical Equipment & Medical Supplies | 5924 Stoneridge Dr, Suite 102, Pleasanton, CA 94588-2887 | 2010-12-03 |
| 1609109412 | Sharmila Acharya | Physical Therapist | 5924 Stoneridge Dr, Suite 206, Pleasanton, CA 94588-2887 | 2009-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932786 | Kabafusion, LLC | Durable Medical Equipment & Medical Supplies | 5860 W. Las Positas Blvd, Suite 19, Pleasanton, CA 94588 | 2020-11-02 |
| 1619519691 | Vanessa Baldwin | Behavior Technician | 5828 Stoneridge Mall Road, Suit 205, Pleasanton, CA 94588 | 2019-10-11 |
| 1184187783 | Amanda Singh | Behavior Technician | 1811 Stoneridge Mall Rd Suite 205, Pleasanton, CA 94588 | 2019-04-10 |
| 1891262192 | Virginia Zamora | Behavior Technician | 5820 Stoneridgemall Rd, Suite 205, Pleasanton, CA 94588 | 2018-10-25 |
| 1891275368 | Ixchel N Baltazar | Behavioral Analyst | 520 Stoneridge Mall Rd, Ste. 205, Pleasanton, CA 94588 | 2018-08-15 |
| 1386149409 | Monique Imanii Brown | Behavioral Analyst | 511 Johnson Drive, Pleasanton, CA 94588 | 2018-03-29 |
| 1922509710 | Cierra Marie Barton | Behavioral Analyst | 5820 Stoneridge Mall Road, Suite 205, Pleasanton, CA 94588 | 2018-02-27 |
| 1851800056 | Delisa Simon | Nurse Practitioner | 4439 Stoneridge Dr Ste 110, Pleasanton, CA 94588 | 2017-09-20 |
| 1831611409 | One Health Hospice, Inc. | Hospice Care, Community Based | 7059 Commerce Cir, Suite G, Pleasanton, CA 94588 | 2017-07-14 |
| 1114478641 | Carlos Gavino | Behavior Technician | 5820 Stoneridge Mall Dr, Suite 205, Pleasanton, CA 94588 | 2016-10-19 |
| Find all providers in zip 94588 | ||||
| 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 |
|---|---|---|---|---|
| 1871139808 | Joseph Dominic Elia | Ophthalmology | 1811 Santa Rita Rd Ste 208, Pleasanton, CA 94566-4732 | 2019-11-25 |
| 1124027495 | Jonathan Lewis Savell | Ophthalmology | 1687 Ramblewood Way, Pleasanton, CA 94566-6027 | 2005-07-19 |
| 1619169943 | Todd A . Auker Md. A Professional Corporation | Ophthalmology | 2324 Santa Rita Rd, Suite 7, Pleasanton, CA 94566-4152 | 2007-08-10 |
| 1144308214 | Wei Jiang | Ophthalmology | 7601 Stoneridge Dr, Pleasanton, CA 94588-4501 | 2006-11-02 |
| 1164525598 | Michael Raymond Gagnon | Ophthalmology | 5575 W Las Positas Blvd, Suite 240, Pleasanton, CA 94588 | 2006-09-07 |
| 1851323273 | Daniel Scott Glantz | Ophthalmology | 7601 Stoneridge Dr, South Building, First Floor, Pleasanton, CA 94588-4501 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790922 | Paul B Kouyoumjian, Md Inc. | Ophthalmology | 18040 Sherman Way Ste 205, Reseda, CA 91335-4631 | 2020-11-04 |
| 1700496320 | William Thomas Parker | Ophthalmology | 5279 Gaylord Pl, San Diego, CA 92117-1034 | 2020-08-07 |
| 1588274724 | Katerina Kurteeva Md Inc | Ophthalmology | 3140 Bear St Ste 100, Costa Mesa, CA 92626-2964 | 2020-08-03 |
| 1285252502 | Eyecare Specialists Medical Group, Inc | Ophthalmology | 58-471 29 Palms Hwy, Yucca Valley, CA 92284-5818 | 2020-07-13 |
| 1407473754 | Janet K. Kim Md, Inc | Ophthalmology | 903 Crenshaw Blvd Ste 105, Los Angeles, CA 90019-1972 | 2020-07-02 |
| 1699392506 | Desert Ophthalmology Medical Corporation | Ophthalmology | 72650 Fred Waring Dr Ste 109, Palm Desert, CA 92260-5008 | 2020-06-26 |
| 1942821566 | Simon Eyes, Inc. | Ophthalmology | 3260 Beard Rd Ste 5, Napa, CA 94558-3466 | 2020-05-05 |
| 1942821905 | Nathan Abraham Md Vision Professionals Inc | Ophthalmology | 24305 Town Center Dr Ste 160, Valencia, CA 91355-1347 | 2020-04-30 |
| 1720609878 | Don Saul Ellis | Ophthalmology | 343 11th St, Del Mar, CA 92014-2607 | 2020-04-29 |
| 1245851534 | Santa Barbara Eyecare Inc., A Professional Medical Corporation | Ophthalmology | 2946 De La Vina St, Santa Barbara, CA 93105-3310 | 2020-04-28 |
| Find all providers with the same taxonomy | ||||
| City | PLEASANTON |
| Zip Code | 94588 |
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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.