Healthcare Provider Details

I. General information

NPI: 1659487700
Provider Name (Legal Business Name): PARAG A NENE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 JEFFERSON ST
OAKLAND CA
94612-1215
US

IV. Provider business mailing address

1919 ADDISON ST STE 204
BERKELEY CA
94704-1143
US

V. Phone/Fax

Practice location:
  • Phone: 510-923-1099
  • Fax: 510-350-8793
Mailing address:
  • Phone: 510-899-7445
  • Fax: 510-647-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00046843
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD00046843
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: