Provider Demographics
NPI:1376626226
Name:WALNUT CREEK SURGICAL ASSOICATES, INC
Entity Type:Organization
Organization Name:WALNUT CREEK SURGICAL ASSOICATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-933-0984
Mailing Address - Street 1:130 LA CASA VIA
Mailing Address - Street 2:BUILDING 3, SUITE 211
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3045
Mailing Address - Country:US
Mailing Address - Phone:925-933-0984
Mailing Address - Fax:925-933-0986
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:BUILDING 3, SUITE 211
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-933-0984
Practice Address - Fax:925-933-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty