Healthcare Provider Details

I. General information

NPI: 1598019085
Provider Name (Legal Business Name): BAY IMAGING CONSULTANTS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20101 LAKE CHABOT RD
CASTRO VALLEY CA
94546-5305
US

IV. Provider business mailing address

2125 OAK GROVE RD STE 200
WALNUT CREEK CA
94598-2520
US

V. Phone/Fax

Practice location:
  • Phone: 925-296-7156
  • Fax:
Mailing address:
  • Phone: 925-296-7156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: ASEEM OM RAWAL
Title or Position: PRESIDENT
Credential:
Phone: 925-296-7150