Provider Demographics
NPI:1003305236
Name:EAST BAY HAND MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:EAST BAY HAND MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR/BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:DENICE
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-297-0550
Mailing Address - Street 1:13690 E 14TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2584
Mailing Address - Country:US
Mailing Address - Phone:510-297-0550
Mailing Address - Fax:510-297-0558
Practice Address - Street 1:13690 E 14TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2584
Practice Address - Country:US
Practice Address - Phone:510-297-0550
Practice Address - Fax:510-297-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75352174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty