Provider Demographics
NPI: | 1164928537 |
---|---|
Name: | EAST BAY NEUROLOGY, INC. |
Entity Type: | Organization |
Organization Name: | EAST BAY NEUROLOGY, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SECRETARY |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | CHIRAG |
Authorized Official - Middle Name: | HASHMUKH |
Authorized Official - Last Name: | PATEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 805-720-4867 |
Mailing Address - Street 1: | 675 YGNACIO VALLEY RD STE A102 |
Mailing Address - Street 2: | |
Mailing Address - City: | WALNUT CREEK |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 94596-3882 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 925-938-5252 |
Mailing Address - Fax: | 925-938-1343 |
Practice Address - Street 1: | 675 YGNACIO VALLEY RD STE A102 |
Practice Address - Street 2: | |
Practice Address - City: | WALNUT CREEK |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94596-3882 |
Practice Address - Country: | US |
Practice Address - Phone: | 925-938-5252 |
Practice Address - Fax: | 925-938-1343 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-04-03 |
Last Update Date: | 2018-04-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Single Specialty |