Provider Demographics
NPI:1629730395
Name:NORTH BAY AMBULATORY SURGERY CENTER (NBASC) LLC
Entity Type:Organization
Organization Name:NORTH BAY AMBULATORY SURGERY CENTER (NBASC) LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:VIALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-828-5973
Mailing Address - Street 1:PO BOX 1312
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95031-1312
Mailing Address - Country:US
Mailing Address - Phone:408-828-5973
Mailing Address - Fax:866-284-9263
Practice Address - Street 1:1850 SULLIVAN AVE STE 400
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2204
Practice Address - Country:US
Practice Address - Phone:650-991-6442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical