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NPI Code Detail

MEDICARE: BERKELEY COMMUNITY HEALTH PROJECT

MEDICARE: BERKELEY COMMUNITY HEALTH PROJECT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568655256
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERKELEY COMMUNITY HEALTH PROJECT
Provider Business Mailing Address
First Line : 2339 DURANT AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94704-1606
Country : US
Telephone Number : 510-548-2570
Fax Number : 510-548-1730
Provider Business Practice Location Address
First Line : 2339 DURANT AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94704-1606
Country : US
Telephone Number : 510-548-2570
Fax Number : 510-548-1730
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. ROBERT KEVESS
Credential : M.D.
Telephone Number : 510-548-2570
Provider Enumeration Date : 08/25/2007
Last Update Date : 08/25/2007

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Directions to “BERKELEY COMMUNITY HEALTH PROJECT ” Practice Location

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