Healthcare Provider Details

I. General information

NPI: 1699824557
Provider Name (Legal Business Name): BAY MTU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/16/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BOCKMAN RD RM 210
SAN LORENZO CA
94580-1903
US

IV. Provider business mailing address

1100 SAN LEANDRO BLVD
SAN LEANDRO CA
94577-1595
US

V. Phone/Fax

Practice location:
  • Phone: 510-317-4355
  • Fax: 510-273-3764
Mailing address:
  • Phone: 510-267-3278
  • Fax: 510-273-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name: JUNE MCINTYRE
Title or Position: CHIEF THERAPIST
Credential: OTD, OTR/L
Phone: 510-267-3278