Provider Demographics
NPI:1194184184
Name:BAY AREA SURGICAL SPECIALISTS, INC
Entity Type:Organization
Organization Name:BAY AREA SURGICAL SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-948-8143
Mailing Address - Street 1:365 LENNON LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5910
Mailing Address - Country:US
Mailing Address - Phone:925-948-8143
Mailing Address - Fax:
Practice Address - Street 1:913 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 186
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4031
Practice Address - Country:US
Practice Address - Phone:925-984-2622
Practice Address - Fax:925-984-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty