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General NPI Number Information
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NPI Number | 1649226242
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Entity Type | Organization
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Legal Business Name | EAST BAY ANESTHESIOLOGY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 350 HAWTHORNE AVE
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City | OAKLAND
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State | CA
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Zip | 94609-3108
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Country | US
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Telephone | 510-655-4000
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Fax | 510-869-8906
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Provider Business Mailing Address
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Address Line | 3000 COLBY ST STE 205
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City | BERKELEY
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State | CA
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Zip | 94705-2058
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Country | US
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Telephone | 510-666-0854
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Fax | 510-666-1192
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUSTIN POLLOCK
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Credential | MD
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Telephone | 301-908-5729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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