EAST BAY ORTHOPAEDIC SPECIALISTS MEDICAL CORPORATION (NPI# 1699820969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699820969 |
| Entity Type | Organization |
| Organization Name | EAST BAY ORTHOPAEDIC SPECIALISTS MEDICAL CORPORATION |
| Practice Address |
350 30th St Ste 530 Oakland CA 94609-3426 |
| Practice Telephone | 5102381468 |
| Practice Fax Number | 5108393796 |
| Mailing Telephone | 5102381468 |
| Mailing Fax Number | 5108393796 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2009-10-07 |
| Authorized Official Name | GEORGE ARTHUR PUGH (PRESIDENT) |
| Authorized Official Telephone | 5102381468 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | G38318 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDI-CAL | 00G383180 | 01 |
| Street Address |
350 30TH ST STE 530 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114964400 | Jeffrey A. Mann | Orthopaedic Surgery | 350 30th St Ste 530, Oakland, CA 94609-3426 | 2006-06-02 |
| 1619482387 | California Sports and Orthopaedic | Orthopaedic Surgery | 350 30th St Ste 530, Oakland, CA 94609-3426 | 2017-12-04 |
| 1700081502 | Basil Alwattar | Orthopaedic Surgery | 350 30th St Ste 530, Oakland, CA 94609-3426 | 2007-06-20 |
| 1669507208 | Sharon Mitchell | Pharmacist | 350 30th St Ste 530, Oakland, CA 94609-3426 | 2007-02-23 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932406519 | Webster Orthopaedic Medica Group, A Professional Corporation | Orthopaedic Surgery | 3300 Webster St Ste 1201, Oakland, CA 94609-3126 | 2011-02-17 |
| 1427265198 | Jack H. Stehr, M.d., Professional Corporation | Orthopaedic Surgery | 350 30th St Ste 424, Oakland, CA 94609-3426 | 2007-05-16 |
| 1881739639 | Michael F. Charles | Orthopaedic Surgery | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1700973708 | Albert Joseph Pepe | Orthopaedic Surgery | 69 County Rd, Oakland, ME 04963-5221 | 2006-10-10 |
| 1548278468 | Scott M Taylor | Orthopaedic Surgery | 400 29th Street, Suite #400, Oakland, CA 94609 | 2006-08-04 |
| 1114964400 | Jeffrey A. Mann | Orthopaedic Surgery | 350 30th St Ste 530, Oakland, CA 94609-3426 | 2006-06-02 |
| 1003866518 | George A. Pugh | Orthopaedic Surgery | 80 Grand Ave Fl 5, Oakland, CA 94612-3725 | 2006-05-12 |
| 1710954649 | William A. Billings | Orthopaedic Surgery | 80 Grand Ave, Suite 400, Oakland, CA 94612-3725 | 2006-02-28 |
| 1578540472 | Terrance Leonard Brown | Orthopaedic Surgery | 421 Fox Hills Ct, Oakland, CA 94605-5015 | 2005-12-30 |
| 1881684363 | Rakesh Donthineni | Orthopaedic Surgery | 5700 Telegraph Avenue, Suite 100, Oakland, CA 94609-1710 | 2005-10-25 |
| 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.