Healthcare Provider Details

I. General information

NPI: 1962761452
Provider Name (Legal Business Name): NEWARK BETH ISRAEL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 17TH ST APT 305
OAKLAND CA
94612-4168
US

IV. Provider business mailing address

245 17TH ST APT 305
OAKLAND CA
94612-4104
US

V. Phone/Fax

Practice location:
  • Phone: 925-360-1876
  • Fax:
Mailing address:
  • Phone: 925-360-1876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. MULUNEH ABEBE
Title or Position: PEDIATRIC RESIDENT
Credential: M.D.
Phone: 945-360-1876