Provider Demographics
NPI:1093167835
Name:BAY AREA ACCOUNTABLE CARE NETWORK, INC
Entity Type:Organization
Organization Name:BAY AREA ACCOUNTABLE CARE NETWORK, INC
Other - Org Name:CANOPY HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-461-5000
Mailing Address - Street 1:15821 VENTURA BLVD.
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-461-5000
Mailing Address - Fax:818-461-5078
Practice Address - Street 1:15821 VENTURA BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2915
Practice Address - Country:US
Practice Address - Phone:818-461-5000
Practice Address - Fax:818-461-5078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization