Provider Demographics
NPI:1063525244
Name:OBERLANDER, MICHAEL ALBERT (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALBERT
Last Name:OBERLANDER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 MT DIABLO BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-3547
Mailing Address - Country:US
Mailing Address - Phone:925-284-5300
Mailing Address - Fax:925-284-5381
Practice Address - Street 1:3717 MT DIABLO BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3547
Practice Address - Country:US
Practice Address - Phone:925-284-5300
Practice Address - Fax:925-284-5381
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65683207XS0114X, 207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
200031045OtherRAILROAD MEDICARE
200031045OtherRAILROAD MEDICARE
E88478Medicare UPIN