Healthcare Provider Details

I. General information

NPI: 1225728579
Provider Name (Legal Business Name): BAY AREA SURGICAL SPECIALISTS, INC. A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 05/10/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 SANTA RITA RD STE 6
PLEASANTON CA
94566-4150
US

IV. Provider business mailing address

2637 SHADELANDS DR
WALNUT CREEK CA
94598-2512
US

V. Phone/Fax

Practice location:
  • Phone: 925-463-0470
  • Fax:
Mailing address:
  • Phone: 925-627-3424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: INEZ WONDEH
Title or Position: CEO
Credential:
Phone: 925-948-8143