Healthcare Provider Details

I. General information

NPI: 1932147568
Provider Name (Legal Business Name): BERKELEY PRIMARY CARE MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 WOOLSEY ST STE 201
BERKELEY CA
94705-1975
US

IV. Provider business mailing address

2320 WOOLSEY ST STE 201
BERKELEY CA
94705-1975
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-7533
  • Fax: 510-848-0105
Mailing address:
  • Phone: 510-848-7533
  • Fax: 510-848-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES E MCLAUGHLIN JR.
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 510-848-7533