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: July 19, 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
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

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.

Dentist (General Practice)
2636 TELEGRAPH AVE
BERKELEY, CA 94704
Family Medicine
2636 TELEGRAPH AVE
BERKELEY, CA 94704
Family Medicine
2636 TELEGRAPH AVE, SUITE A
BERKELEY, CA 94704
Family Medicine
2636 TELEGRAPH AVE, SUITE A
BERKELEY, CA 94704
Family Medicine
2636 TELEGRAPH AVE
BERKELEY, CA 94704

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1821104100, enumerated as an "organization" on August 21, 2006.

The provider is located at 2636 TELEGRAPH AVE BERKELEY, CA 94704 and the phone number is (510) 841-1647.

Family Medicine with taxonomy code 207Q00000X.