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NPI Code Detail

MEDICARE: HARRISON JACOB ALTER MD

MEDICARE: HARRISON JACOB ALTER MD
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
1207P00000XEmergency Medicine PhysicianG80744CA

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 : 1972584415
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRISON JACOB ALTER MD
Provider Business Mailing Address
First Line : 1511 GRANT ST
Second Line :
City : BERKELEY
State : CA
Zip : 94703-1133
Country : US
Telephone Number : 510-225-8406
Fax Number :
Provider Business Practice Location Address
First Line : 1404 FRANKLIN ST STE 200
Second Line :
City : OAKLAND
State : CA
Zip : 94612-3208
Country : US
Telephone Number : 510-891-8950
Fax Number : 510-832-2104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 06/09/2025

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