Provider Demographics
NPI:1285754234
Name:THE WEST OAKLAND HEALTH COUNCIL
Entity type:Organization
Organization Name:THE WEST OAKLAND HEALTH COUNCIL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-835-9610
Mailing Address - Street 1:700 ADELINE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2608
Mailing Address - Country:US
Mailing Address - Phone:510-835-9610
Mailing Address - Fax:510-272-0209
Practice Address - Street 1:7450 INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2806
Practice Address - Country:US
Practice Address - Phone:510-430-9401
Practice Address - Fax:510-255-2316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE WEST OAKLAND HEALTH COUNCIL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-30
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA140000028261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1285754234Medicare UPIN