Provider Demographics
NPI:1225578453
Name:BAYCHILDREN'S PHYSICIANS
Entity Type:Organization
Organization Name:BAYCHILDREN'S PHYSICIANS
Other - Org Name:UBCP HILLTOP PEDIATRICS
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEYHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-476-4407
Mailing Address - Street 1:6475 CHRISTIE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1095
Mailing Address - Country:US
Mailing Address - Phone:415-476-4407
Mailing Address - Fax:
Practice Address - Street 1:2970 HILLTOP MALL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1947
Practice Address - Country:US
Practice Address - Phone:510-222-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYCHILDREN'S PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty