MEDICARE: BAY AREA CARDIOLOGY MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114900396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA CARDIOLOGY MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1133 E STANLEY BLVD
Second Line	:	SUITE 207
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4200
Country	:	US
Telephone Number	:	925-294-9037
Fax Number	:	925-294-9272

Provider Business Practice Location Address
First Line	:	1133 E STANLEY BLVD
Second Line	:	SUITE 207
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4200
Country	:	US
Telephone Number	:	925-294-9037
Fax Number	:	925-294-9272

Authorized Official
Title or Position	:	PARTNER
Name	:	AYMAN A HOSNY
Credential	:	M.D.
Telephone Number	:	925-294-9037

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	08/22/2020

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