Provider Demographics
NPI:1083171268
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:BASS MEDICAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT, 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:925-215-4540
Practice Address - Street 1:1208 E ARQUES AVE STE 113
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5419
Practice Address - Country:US
Practice Address - Phone:408-730-8082
Practice Address - Fax:087-300-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic