CARBON HEALTH PRIMARY CARE OF CALIFORNIA PC
NPI 1972057990
Clinic/Center - Multi-Specialty in Berkeley, CA
NPI Status: Active since August 08, 2016
Contact Information
2920 TELEGRAPH AVE STE 100
BERKELEY, CA
ZIP 94705
Phone: (510) 686-3621
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 05D2278999
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-27-2027
About CARBON HEALTH PRIMARY CARE OF CALIFORNIA PC
This page provides the complete NPI Profile along with additional information for Carbon Health Primary Care Of California Pc, a provider established in Berkeley, California operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1972057990 assigned on August 2016. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated June 2025. Carbon Health Primary Care Of California Pc operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Marley Page (Director)
- NPI
- 1972057990
- Provider Name
- CARBON HEALTH PRIMARY CARE OF CALIFORNIA PC
- Entity Type
- Organization
- Location Address
- 2920 TELEGRAPH AVE STE 100 BERKELEY, CA 94705
- Location Phone
- (510) 686-3621
- Mailing Address
- 2100 FRANKLIN ST STE 355 OAKLAND, CA 94612
- Mailing Phone
- (415) 200-2099
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-08-2016
- Last Update Date
- 06-24-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
| 2 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 3 | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2278999
- Facility Type
- Physician Office
- Certificate Effective Date
- March 28, 2025
- Certificate Expiration Date
- March 27, 2027
- Laboratory Director
- SUJAL MANDAVIA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Carbon Health Primary Care Of California Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 7 | 2 | 0 | 5 | 7 | 9 | 9 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 14 | 2 | 0 | 5 | 14 | 9 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 1 + 4 + 2 + 0 + 5 + 1 + 4 + 9 + 1 + 8 + 24 = 70 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1972057990 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114553419 | IRENE OROZCO NP Individual | Nurse Practitioner | 2920 TELEGRAPH AVE STE 100 BERKELEY, CA 94705 (510) 686-3621 |
| 1689111759 | MRS. JORDAN FAULKNER MSPAS, PA-C Individual | Physician Assistant | 2920 TELEGRAPH AVE STE 100 BERKELEY, CA 94705 (949) 549-5401 |
| 1881341576 | CARBON HEALTH PRIMARY CARE OF CALIFORNIA PC Organization | Non-Pharmacy Dispensing Site | 2920 TELEGRAPH AVE STE 100 BERKELEY, CA 94705 (510) 686-3621 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1972057990, enumerated in the NPI registry as an "organization" on August 08, 2016
The provider is located at 2920 Telegraph Ave Ste 100 Berkeley, Ca 94705 and the phone number is (510) 686-3621
This medical organization specializes in Clinic/Center with taxonomy code 261QM1300X with a focus in Multi-Specialty
The provider's CLIA number is 05D2278999 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on August 08, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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