Provider Demographics
NPI:1629154281
Name:LISA BAILEY AND ASSOCIATES, A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:LISA BAILEY AND ASSOCIATES, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:BAY AREA BREAST SURGEONS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-835-9900
Mailing Address - Street 1:3300 WEBSTER ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3117
Mailing Address - Country:US
Mailing Address - Phone:510-835-9900
Mailing Address - Fax:510-835-9909
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:SUITE 212
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3117
Practice Address - Country:US
Practice Address - Phone:510-835-9900
Practice Address - Fax:510-835-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty