Provider Demographics
NPI:1073087755
Name:BAY AREA SURGICAL SPECIALISTS, INC A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:BAY AREA SURGICAL SPECIALISTS, INC A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-932-6330
Mailing Address - Street 1:2637 SHADELANDS DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2512
Mailing Address - Country:US
Mailing Address - Phone:925-948-8143
Mailing Address - Fax:
Practice Address - Street 1:2 FIFER AVE STE 130
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1174
Practice Address - Country:US
Practice Address - Phone:925-287-1256
Practice Address - Fax:925-287-0913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA SURGICAL SPECIALISTS INC A MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty