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General NPI Number Information
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NPI Number | 1205215563
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Entity Type | Organization
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Legal Business Name | CHILDRENS HOSPITAL & RESEARCH CENTER AT OAKLAND
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 747 52ND ST
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3331
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Fax |
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Provider Business Mailing Address
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Address Line | 965 HILLDALE AVE
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City | BERKELEY
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State | CA
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Zip | 94708-1438
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Country | US
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Telephone | 630-947-9101
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Fax |
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Authorized Official
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Title or Position | RESIDENCY PROGRAM COORDINATOR
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Name | KATHERINE CASTILLO
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Credential |
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Telephone | 510-428-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State |
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