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General NPI Number Information
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NPI Number | 1821783903
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Entity Type | Organization
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Legal Business Name | BAY SENIOR MEDICAL HOUSE CLINIC PC
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 34220 ANGUS COURT
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City | FREMONT
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State | CA
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Zip | 94555
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Country | US
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Telephone | 510-417-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 39899 BALENTINE DR STE 200
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City | NEWARK
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State | CA
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Zip | 94560-5361
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Country | US
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Telephone | 510-417-8733
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHUI LEUNG
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Credential |
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Telephone | 510-417-8733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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