Healthcare Provider Details

I. General information

NPI: 1164678223
Provider Name (Legal Business Name): BAY IMAGING CONSULTANTS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 TELEGRAPH AVE
OAKLAND CA
94609-1710
US

IV. Provider business mailing address

2125 OAK GROVE RD SUITE 200
WALNUT CREEK CA
94598-2536
US

V. Phone/Fax

Practice location:
  • Phone: 925-296-7156
  • Fax: 925-296-7174
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 State

VIII. Authorized Official

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