Provider Demographics
NPI:1851796718
Name:NEDER, NEIL (CPT)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:
Last Name:NEDER
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:801 MARINA WAY S
Mailing Address - Street 2:STE 2
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-3745
Mailing Address - Country:US
Mailing Address - Phone:510-868-6030
Mailing Address - Fax:510-868-0844
Practice Address - Street 1:801 MARINA WAY S
Practice Address - Street 2:STE 2
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804-3745
Practice Address - Country:US
Practice Address - Phone:510-868-6030
Practice Address - Fax:510-868-0844
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CACPT00053443246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy