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BERKELEY FAMILY PRACTICE MEDICAL GROUP
NPI 1821104100
Family Medicine in Berkeley, CA

Active since August 21, 2006CLIA 05D0942853 · Waiver
2636 TELEGRAPH AVE, BERKELEY, CA 94704(510) 841-1647(510) 848-4924 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 6, 2023, Jul 29, 2022 (2 updates tracked since 2022).

About Berkeley Family Practice Medical Group NPPES

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

BERKELEY FAMILY PRACTICE MEDICAL GROUP (NPI 1821104100) is a healthcare organization registered as a family medicine in Berkeley, California and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through March 17, 2028 and lists Loren Palacios, Administrator, as its authorized official.

NPPES Registry Identity

NPI1821104100
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTIMOTHY A FITZER MD INC A PROFESSIONAL MEDICAL CORPORATION
Location Address2636 TELEGRAPH AVEBerkeley, CA 94704-3322
Mailing Address2636 Telegraph Ave Ste ABerkeley, CA 94704-3373 · (510) 841-1647 · Fax (510) 848-4924
Phone(510) 841-1647
Fax(510) 848-4924
Organization SubpartNo
Authorized OfficialLoren PalaciosAdministrator · (510) 841-1647
Enumeration DateAugust 21, 2006
Last NPPES UpdateDecember 6, 20232 updates tracked since enumeration
NPPES CertifiedDecember 6, 2023
✔ NPI 1821104100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2636 TELEGRAPH AVE, Berkeley, CA 94704
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Other Names 1

Doing Business AsBerkeley Family Practice Medical 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

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 05D0942853

Berkeley Family Practice · Berkeley, CA
Active · expires Mar 17, 2028
CLIA Number05D0942853
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorThomas K. Stern
Laboratory Phone(510) 841-1647
Laboratory LocationBerkeley Family Practice2636 Telegraph Ave, Berkeley, CA 94704
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RENA TACDOL MD
Family Medicine
2636 TELEGRAPH AVE
BERKELEY, CA 94704
Alameda County (510) 841-1647
DR. AYSHA ZAHRA ZAMAN MD
Family Medicine
2636 TELEGRAPH AVE, SUITE A
BERKELEY, CA 94704
Alameda County (510) 841-1647
DR. HAROLD CARLETON CRANGLE DDS
Dentist (General Practice)
2636 TELEGRAPH AVE
BERKELEY, CA 94704
Alameda County (510) 841-6357
DR. TIM A FITZER MD
Family Medicine
2636 TELEGRAPH AVE
BERKELEY, CA 94704
Alameda County (510) 841-1647
DR. MUKULIKA MEHTA M.D.,
Family Medicine
2636 TELEGRAPH AVE, SUITE A
BERKELEY, CA 94704
Alameda County (510) 841-1647

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 Timothy A Fitzer MD Inc A Professional Medical Corporation's NPI number?

The NPI number for Timothy A Fitzer MD Inc A Professional Medical Corporation is 1821104100. It was assigned to this organization in the NPPES registry on August 21, 2006. The provider is doing business as Berkeley Family Practice Medical Group.

Where is Timothy A Fitzer MD Inc A Professional Medical Corporation located?

Timothy A Fitzer MD Inc A Professional Medical Corporation is located at 2636 Telegraph Ave, Berkeley, CA 94704. The listed phone number is (510) 841-1647.

What is Timothy A Fitzer MD Inc A Professional Medical Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Timothy A Fitzer MD Inc A Professional Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0942853) is associated with this NPI, valid through March 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Timothy A Fitzer MD Inc A Professional Medical Corporation was last updated on December 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.