Provider Demographics
NPI:1710936653
Name:RANU GREWAL-BAHL MD
Entity Type:Organization
Organization Name:RANU GREWAL-BAHL MD
Other - Org Name:ALAMEDA RADIATION ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DERENZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-732-6930
Mailing Address - Street 1:27204 CALAROGA AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4339
Mailing Address - Country:US
Mailing Address - Phone:510-732-6930
Mailing Address - Fax:510-732-1357
Practice Address - Street 1:27204 CALAROGA AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4339
Practice Address - Country:US
Practice Address - Phone:510-732-6930
Practice Address - Fax:510-732-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA039529174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE35204Medicare UPIN
CA00A395291Medicare ID - Type Unspecified