Provider Demographics
NPI:1164678058
Name:BAY IMAGING CONSULTANTS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:BAY IMAGING CONSULTANTS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASEEM
Authorized Official - Middle Name:OM
Authorized Official - Last Name:RAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-296-7108
Mailing Address - Street 1:2125 OAK GROVE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2520
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7174
Practice Address - Street 1:300 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2574
Practice Address - Country:US
Practice Address - Phone:925-296-7156
Practice Address - Fax:925-296-7174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMMM00068MMedicare PIN
CAZZZ30340ZMedicare PIN
CACE9979Medicare PIN