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NPI Code Detail

MEDICARE: BAY AREA REHABILITATION MEDICAL GROUP

MEDICARE: BAY AREA REHABILITATION 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
1208100000XPhysical Medicine & Rehabilitation PhysicianG450270CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CP1128OTHERCAGROUP MCRERR
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770586380
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAY AREA REHABILITATION MEDICAL GROUP
Provider Business Mailing Address
First Line : 2250 HAYES ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-1013
Country : US
Telephone Number : 415-750-5761
Fax Number : 415-666-0210
Provider Business Practice Location Address
First Line : 1000 GREENLEY RD
Second Line :
City : SONORA
State : CA
Zip : 95370-5200
Country : US
Telephone Number : 209-536-5040
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : BARBARA L BAMMANN
Credential : M.D.
Telephone Number : 209-536-5040
Provider Enumeration Date : 05/27/2005
Last Update Date : 05/14/2008

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Directions to “BAY AREA REHABILITATION MEDICAL GROUP ” Practice Location

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