Healthcare Provider Details
I. General information
NPI: 1043375561
Provider Name (Legal Business Name): EAST BAY NEWBORN SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
747 52ND ST NEONATOLOGY OFFICE
OAKLAND CA
94609-1809
US
IV. Provider business mailing address
747 52ND ST NEONATOLOGY OFFICE
OAKLAND CA
94609-1809
US
V. Phone/Fax
- Phone: 510-428-3276
- Fax: 510-428-3542
- Phone: 510-428-3276
- Fax: 510-428-3542
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ARTHUR
E
D'HARLINGUE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 510-428-3276