Healthcare Provider Details

I. General information

NPI: 1891801122
Provider Name (Legal Business Name): BAY AREA GYNECOLOGY ONCOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 CAMPISI WAY STE 2A
CAMPBELL CA
95008-2351
US

IV. Provider business mailing address

PO BOX 33235
LOS GATOS CA
95031-3235
US

V. Phone/Fax

Practice location:
  • Phone: 408-827-4274
  • Fax: 408-827-4275
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA068842
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG85643
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES FREDERICK LILJA
Title or Position: DIRECTOR
Credential: M.D.
Phone: 408-827-4274