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General NPI Number Information
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NPI Number | 1174598098
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Entity Type | Organization
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Legal Business Name | BG MEDICAL, INC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 239 MAIN ST STE B
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City | PLEASANTON
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State | CA
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Zip | 94566-8220
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Country | US
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Telephone | 415-847-7147
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 ESSEX ST
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City | LIVERMORE
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State | CA
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Zip | 94550-5538
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Country | US
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Telephone | 415-847-7147
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT L BAKER
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Credential | PT, PHD, MBA, OCS
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Telephone | 415-847-7147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT13568
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License Number State | CA
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