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General NPI Number Information
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NPI Number | 1265187272
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Entity Type | Organization
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Legal Business Name | BAY AREA MOBILE MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 121 PAUL DR STE A
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2047
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Country | US
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Telephone | 415-766-1569
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Fax |
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Provider Business Mailing Address
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Address Line | 121 PAUL DR STE A
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2047
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Country | US
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Telephone | 415-766-1569
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | IZAH SINGERMAN
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Credential |
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Telephone | 415-766-1569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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