Provider Demographics
NPI:1609317015
Name:BAYCHILDREN'S PHYSICIANS
Entity Type:Organization
Organization Name:BAYCHILDREN'S PHYSICIANS
Other - Org Name:UBCP MFM PRACTICE
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:415-476-4424
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:
Mailing Address - Fax:
Practice Address - Street 1:350 30TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3424
Practice Address - Country:US
Practice Address - Phone:510-444-0790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYCHILDREN'S PHYSICIANS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty