Healthcare Provider Details

I. General information

NPI: 1497257950
Provider Name (Legal Business Name): BAYCHILDREN'S PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 CAMINO DIABLO STE 200
WALNUT CREEK CA
94597-4001
US

IV. Provider business mailing address

6475 CHRISTIE AVE STE 300
EMERYVILLE CA
94608-2263
US

V. Phone/Fax

Practice location:
  • Phone: 925-979-9360
  • Fax:
Mailing address:
  • Phone: 415-476-4407
  • Fax: 415-353-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIE HALLGREN
Title or Position: ASSOC DIRECTOR REVENUE CYCLE
Credential:
Phone: 415-476-4404