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EAST BAY NEPHROLOGY MEDICAL GROUP, INC.
NPI 1184719809
Internal Medicine - Nephrology in Vallejo, CA

Active since October 04, 2006CLIA Certified · 3 labs
125 HOSPITAL DR, VALLEJO, CA 94589(510) 841-4525(510) 848-9970 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About East Bay Nephrology Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST BAY NEPHROLOGY MEDICAL GROUP, INC. (NPI 1184719809) is a healthcare organization registered as a nephrology in Vallejo, California and active in the NPI registry since October 2006. The organization holds 3 active CLIA laboratory certificates and lists Thomas A Turner, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1184719809
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameEAST BAY NEPHROLOGY MEDICAL GROUP, INC.
Location Address125 HOSPITAL DRVallejo, CA 94589-2562
Mailing Address2905 Telegraph AveBerkeley, CA 94705-2063 · (510) 841-0411 · Fax (510) 845-5030
Phone(510) 841-4525
Fax(510) 848-9970
Organization SubpartNo
Authorized OfficialThomas A TurnerChief Operating Officer · (510) 841-0411
Enumeration DateOctober 4, 2006
Last NPPES UpdateJuly 21, 2022
✔ NPI 1184719809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
125 HOSPITAL DR, Vallejo, CA 94589
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Other Identifiers 2

MedicaidGR0049641CA
OtherCR0683CA · Railroad Medicare Group #

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0701825

East Bay Nephrology Medical Group Inc · Berkeley, CA
Active · expires Aug 31, 2026
CLIA Number05D0701825
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSamuel Wong
Laboratory Phone(510) 841-4525
Laboratory LocationEast Bay Nephrology Medical Group Inc2905 Telegraph Ave, Berkeley, CA 94705
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D0701826

East Bay Nephrology Medical Group Inc · Vallejo, CA
Active · expires Aug 31, 2026
CLIA Number05D0701826
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorClaudia I. Iota-Herbei
Laboratory Phone(707) 642-7510
Laboratory LocationEast Bay Nephrology Medical Group Inc125 Hospital Drive, Vallejo, CA 94589
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D0924004

East Bay Nephrology Medical Group Inc · Oakland, CA
Active · expires Apr 17, 2027
CLIA Number05D0924004
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorOliver K. Khakmahd
Laboratory Phone(510) 841-4525
Laboratory LocationEast Bay Nephrology Medical Group Inc3043 Summit St, Oakland, CA 94609
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Bay Nephrology Medical Group, Inc.'s NPI number?

The NPI number for East Bay Nephrology Medical Group, Inc. is 1184719809. It was assigned to this organization in the NPPES registry on October 4, 2006.

Where is East Bay Nephrology Medical Group, Inc. located?

East Bay Nephrology Medical Group, Inc. is located at 125 Hospital Dr, Vallejo, CA 94589. The listed phone number is (510) 841-4525.

What is East Bay Nephrology Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Does East Bay Nephrology Medical Group, Inc. hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for East Bay Nephrology Medical Group, Inc. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.