Provider Demographics
NPI:1962812800
Name:BERKELEY ENDOCRINE CLINIC, INC.
Entity Type:Organization
Organization Name:BERKELEY ENDOCRINE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:MURAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-883-9005
Mailing Address - Street 1:3000 COLBY ST
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2083
Mailing Address - Country:US
Mailing Address - Phone:510-883-9005
Mailing Address - Fax:510-883-9006
Practice Address - Street 1:3000 COLBY ST
Practice Address - Street 2:SUITE 203B
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2083
Practice Address - Country:US
Practice Address - Phone:510-883-9005
Practice Address - Fax:510-883-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115859207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty