Healthcare Provider Details

I. General information

NPI: 1770826869
Provider Name (Legal Business Name): LAURA ALYCIA BATTLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HAWTHORNE AVE STE 2304
OAKLAND CA
94609-3108
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 510-869-6786
  • Fax: 510-869-8375
Mailing address:
  • Phone: 510-869-6786
  • Fax: 510-869-8375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number1096582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: