Healthcare Provider Details

I. General information

NPI: 1417079161
Provider Name (Legal Business Name): ALENA PERSHAY CERT SONOGRAPHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALENA RUBANOVA MD CERT SONOGRAPHER

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 30TH ST SUITE 320
OAKLAND CA
94609-3424
US

IV. Provider business mailing address

350 30TH ST SUITE 320
OAKLAND CA
94609-3424
US

V. Phone/Fax

Practice location:
  • Phone: 510-965-6700
  • Fax: 510-465-7765
Mailing address:
  • Phone: 510-965-6700
  • Fax: 510-465-7765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: