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NPI Code Detail

MEDICARE: B&G PA MEDICAL SERVICES

MEDICARE: B&G PA MEDICAL SERVICES
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
1363A00000XPhysician AssistantPA11993CA

General Provider Information

NPI Number : 1356660302
Entity Type Code : Organization
Provider Name (Legal Business Name) : B&G PA MEDICAL SERVICES
Provider Business Mailing Address
First Line : 4027 BANCROFT DR.
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762
Country : US
Telephone Number : 916-933-4050
Fax Number :
Provider Business Practice Location Address
First Line : 4027 BANCROFT DR
Second Line :
City : EL DORADO HILLS
State : CA
Zip : 95762-6935
Country : US
Telephone Number : 916-933-4050
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. GARY NELSON DUNAYE
Credential : PA
Telephone Number : 916-801-6988
Provider Enumeration Date : 05/28/2010
Last Update Date : 05/28/2010

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Directions to “B&G PA MEDICAL SERVICES ” Practice Location

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