Provider Demographics
NPI:1073636064
Name:BATES, ERNEST A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:A
Last Name:BATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EMBARCADERO CTR
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-5900
Mailing Address - Country:US
Mailing Address - Phone:415-788-5300
Mailing Address - Fax:415-788-5660
Practice Address - Street 1:4 EMBARCADERO CTR
Practice Address - Street 2:SUITE 3700
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-5900
Practice Address - Country:US
Practice Address - Phone:415-788-5300
Practice Address - Fax:415-788-5660
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-13036174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38867Medicare UPIN