ASSOCIATED NEUROLOGY MEDICAL GROUP, INC. (NPI# 1922205442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922205442 |
| Entity Type | Organization |
| Organization Name | ASSOCIATED NEUROLOGY MEDICAL GROUP, INC. |
| Practice Address |
365 Hawthorne Ave Suite 203 Oakland CA 94609-3107 |
| Practice Telephone | 5108345778 |
| Mailing Telephone | 5108345778 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RANDALL ROBERT STARKEY (PRESIDENT OF CORPORATION) |
| Authorized Official Telephone | 5108345778 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
C1233914 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0017862 | 05 |
| Street Address |
365 HAWTHORNE AVE SUITE 203 |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184686156 | Rupert Roupen Horoupian | Specialist | 365 Hawthorne Ave, Suite 101, Oakland, CA 94609-3107 | 2006-04-05 |
| 1588061378 | First Surgical Consultants | General Acute Care Hospital | 365 Hawthorne Ave, 101, Oakland, CA 94609-3107 | 2014-11-24 |
| 1477826683 | Kelley Lockwood Brennan | Nurse Practitioner | 365 Hawthorne Ave, Suite 301, Oakland, CA 94609-3107 | 2012-02-17 |
| 1891084117 | Debbie Choi Man Chan | Physician Assistant | 365 Hawthorne Ave, #201, Oakland, CA 94609-3107 | 2011-04-07 |
| 1679701858 | Cheruba Prabakar | Obstetrics & Gynecology | 365 Hawthorne Ave, Ste 301, Oakland, CA 94609-3107 | 2009-06-26 |
| 1487813697 | Christa Kong | Physician Assistant | 365 Hawthorne Ave, Suite 201, Oakland, CA 94609-3107 | 2008-06-03 |
| 1720284011 | Thomas Raymond Hardey | Clinical Neuropsychologist | 365 Hawthorne Ave, Suite 104, Oakland, CA 94609-3107 | 2007-06-22 |
| 1992913859 | Diane Kwan | Surgery | 365 Hawthorne Ave, Suite 101, Oakland, CA 94609-3107 | 2007-05-21 |
| 1598806986 | Douglas Stannage Patton | Surgery | 365 Hawthorne Ave, Suite 101, Oakland, CA 94609 | 2007-02-09 |
| 1639233687 | Robert Norman Nelson | Obstetrics & Gynecology | 365 Hawthorne Ave, #301, Oakland, CA 94609 | 2006-12-21 |
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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 |
| Find all providers in zip 94609 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477760866 | Janice M. Garvey | Psychiatry & Neurology | 7677 Oakport St, Rceb Suite 300, Oakland, CA 94621-1929 | 2007-05-17 |
| 1134562234 | Nathan Gaines | Psychiatry & Neurology | 1411 E 31st St, Oakland, CA 94602 | 2013-04-09 |
| 1639319718 | Lauren Marie Oommen | Psychiatry & Neurology | 1411 E 31st St, Oakland, CA 94602-1018 | 2009-03-02 |
| 1013183813 | Iris Yung | Psychiatry & Neurology | 3701 Broadway, Oakland, CA 94611-5613 | 2008-05-01 |
| 1871773804 | Dr. Stewart Callis | Psychiatry & Neurology | 317 E Oak St, Oakland, MD 21550-1503 | 2007-11-07 |
| 1386789147 | Thomas W Wallace | Psychiatry & Neurology | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1164567053 | Jacquelyn A Weiss | Psychiatry & Neurology | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1235274192 | Frederic H. Newton | Psychiatry & Neurology | 180 Grand Ave Ste 100, Oakland, CA 94612-3766 | 2007-02-20 |
| 1265574388 | Judy Chang | Psychiatry & Neurology | 818 Webster St, Oakland, Oakland, CA 94607-4220 | 2007-02-13 |
| 1508916321 | Atefeh Hosseini | Psychiatry & Neurology | 275 W Macarthur, Oakland, CA 94611-5641 | 2007-01-12 |
| 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.