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General NPI Number Information
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NPI Number | 1952418378
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Entity Type | Organization
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Legal Business Name | NORTH BAY EYE ASSOCIATES A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 50 PROFESSIONAL CENTER DR SUITE 210
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City | ROHNERT PARK
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State | CA
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Zip | 94928-2164
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Country | US
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Telephone | 707-588-7939
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Fax | 707-588-7941
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Provider Business Mailing Address
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Address Line | 50 PROFESSIONAL CENTER DR SUITE 210
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City | ROHNERT PARK
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State | CA
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Zip | 94928-2164
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Country | US
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Telephone | 707-588-7939
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Fax | 707-588-7941
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Authorized Official
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Title or Position | DIRECTOR
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Name | WILLIAM H BARTLETT
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Credential | MD
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Telephone | 707-544-3375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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