Basic Information
Provider Information
NPI: 1154519072
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: ELOA
MiddleName: S.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 W MACARTHUR BLVD
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115641
CountryCode: US
TelephoneNumber: 5107521000
FaxNumber: 6504985560
Practice Location
Address1: 275 W MACARTHUR BLVD
Address2:  
City: OAKLAND
State: CA
PostalCode: 946115641
CountryCode: US
TelephoneNumber: 5107521000
FaxNumber: 6504985560
Other Information
ProviderEnumerationDate: 10/04/2007
LastUpdateDate: 12/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0203XA91239CAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine

No ID Information.


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