Healthcare Provider Details
I. General information
NPI: 1467277962
Provider Name (Legal Business Name): EAST BAY SURGICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2024
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2540 EAST ST
CONCORD CA
94520-1960
US
IV. Provider business mailing address
PO BOX 4421
WALNUT CREEK CA
94596-0421
US
V. Phone/Fax
- Phone: 925-487-1398
- Fax:
- Phone: 925-487-1398
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2088F0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRIAN
HOPKINS
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 925-487-1398