MEDICARE: BAYSIDE MEDICAL AND NURSING INC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1952157273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYSIDE MEDICAL AND NURSING INC

Provider Business Mailing Address
First Line	:	1571 BROOKVALE DR APT 1
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-4623
Country	:	US
Telephone Number	:	650-404-7682
Fax Number	:

Provider Business Practice Location Address
First Line	:	1571 BROOKVALE DR APT 1
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-4623
Country	:	US
Telephone Number	:	650-404-7682
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	KUSUM REGMI
Credential	:
Telephone Number	:	650-404-7682

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	09/29/2024

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Directions to “BAYSIDE MEDICAL AND NURSING INC ” Practice Location

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