Provider Demographics
NPI:1578292082
Name:GREGORY ALTER GROUP
Entity Type:Organization
Organization Name:GREGORY ALTER GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:510-734-0885
Mailing Address - Street 1:3093 BROADWAY
Mailing Address - Street 2:UNIT PH-76
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5779
Mailing Address - Country:US
Mailing Address - Phone:510-734-0885
Mailing Address - Fax:510-217-3588
Practice Address - Street 1:3093 BROADWAY
Practice Address - Street 2:UNIT PH76
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5779
Practice Address - Country:US
Practice Address - Phone:510-734-0885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty