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General NPI Number Information
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NPI Number | 1568577997
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Entity Type | Organization
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Legal Business Name | BAY AREA PEDIATRIC PULMONARY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 06/09/2009
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Provider Practice Location Address
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Address Line | 747 52ND ST SUITE 5409
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3305
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Fax | 510-597-7154
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Provider Business Mailing Address
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Address Line | 747 52ND ST SUITE 5409
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City | OAKLAND
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State | CA
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Zip | 94609-1809
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Country | US
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Telephone | 510-428-3305
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Fax | 510-597-7154
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. KAREN ANN HARDY
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Credential | M.D.
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Telephone | 510-428-3885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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License Number State | CA
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