Provider Demographics
NPI:1043245541
Name:BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.
Entity Type:Organization
Organization Name:BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.
Other - Org Name:BMA OAKLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAWCETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-662-1237
Mailing Address - Street 1:3012 SUMMIT ST
Mailing Address - Street 2:SUITE 6630
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3480
Mailing Address - Country:US
Mailing Address - Phone:510-893-2060
Mailing Address - Fax:510-835-1529
Practice Address - Street 1:3012 SUMMIT ST
Practice Address - Street 2:SUITE 6630
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3480
Practice Address - Country:US
Practice Address - Phone:510-893-2060
Practice Address - Fax:510-835-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR02534FMedicaid
052534Medicare ID - Type Unspecified