Provider Demographics
NPI:1841769080
Name:BAY AREA MULTI-SPECIALTY GROUP
Entity Type:Organization
Organization Name:BAY AREA MULTI-SPECIALTY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PUSHPA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURSAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-797-1051
Mailing Address - Street 1:37553 FREMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-3706
Mailing Address - Country:US
Mailing Address - Phone:559-323-5660
Mailing Address - Fax:
Practice Address - Street 1:37553 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-3706
Practice Address - Country:US
Practice Address - Phone:559-323-5660
Practice Address - Fax:559-298-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty