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General NPI Number Information
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NPI Number | 1982726576
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Entity Type | Organization
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Legal Business Name | BAY SURGEONS MEDICAL GROUP
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 3798 JANES RD STE 6
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City | ARCATA
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State | CA
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Zip | 95521-4753
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Country | US
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Telephone | 707-822-2279
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Fax | 707-464-9593
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Provider Business Mailing Address
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Address Line | 1225 MARSHALL ST STE 7
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City | CRESCENT CITY
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State | CA
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Zip | 95531-2281
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Country | US
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Telephone | 707-464-6372
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Fax | 707-464-9593
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Authorized Official
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Title or Position | CEO
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Name | DR. ALAN F KREMEN
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Credential | MD
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Telephone | 530-532-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 00G569970
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License Number State | CA
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