1043245541 NPI number — BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043245541 NPI number — BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043245541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3012 SUMMIT ST
Provider Second Line Business Mailing Address:
SUITE 6630
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94609-3480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-893-2060
Provider Business Mailing Address Fax Number:
510-835-1529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3012 SUMMIT ST
Provider Second Line Business Practice Location Address:
SUITE 6630
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94609-3480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-893-2060
Provider Business Practice Location Address Fax Number:
510-835-1529
Provider Enumeration Date:
07/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FAWCETT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
800-662-1237

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ZZR02534F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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