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General NPI Number Information
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NPI Number | 1497144257
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Entity Type | Organization
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Legal Business Name | BAYCHILDREN'S MEDICAL GROUP
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Dates
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Enumeration Date | 01/16/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 6475 CHRISTIE AVE SUITE 300
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City | EMERYVILLE
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State | CA
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Zip | 94608-1095
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Country | US
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Telephone | 415-476-7220
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Fax |
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Provider Business Mailing Address
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Address Line | 6475 CHRISTIE AVE SUITE 300
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City | EMERYVILLE
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State | CA
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Zip | 94608-1095
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Country | US
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Telephone | 415-476-7220
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Fax | 415-353-8200
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CAROLYN APPENZELLER
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Credential | RN, MSN
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Telephone | 415-476-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal 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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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