Provider Demographics
NPI:1295934990
Name:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:510-428-3027
Mailing Address - Street 1:747 52ND STREET
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3407
Mailing Address - Fax:
Practice Address - Street 1:312 CLAY ST STE 150
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-3510
Practice Address - Country:US
Practice Address - Phone:510-428-3408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health