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NPI Code Detail

MEDICARE: PAUL J. BAYARD MD

MEDICARE: PAUL J. BAYARD MD
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
1207Q00000XFamily Medicine PhysicianG74328CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ79046ZOTHERCAMEDICARE PROVIDER NUMBER
2051822OTHERCAFQHC MEDICARE PROVIDER #
3551975OTHERCAFQHC MEDICARE PROVIDER #
4ZZZ29799ZOTHERCAMEDICARE PROVIDER NUMBER

General Provider Information

NPI Number : 1922101237
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL J. BAYARD MD
Provider Business Mailing Address
First Line : PO BOX 22210
Second Line :
City : OAKLAND
State : CA
Zip : 94623-2210
Country : US
Telephone Number : 510-535-4000
Fax Number : 510-535-4189
Provider Business Practice Location Address
First Line : 3451 E 12TH ST
Second Line : 2ND FLOOR
City : OAKLAND
State : CA
Zip : 94601-3463
Country : US
Telephone Number : 510-535-3500
Fax Number : 510-535-4187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 10/14/2014

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