Provider Demographics
NPI:1992838437
Name:BAY AREA CONSORTIUM FOR QUALITY HEALTH CARE, INC.
Entity Type:Organization
Organization Name:BAY AREA CONSORTIUM FOR QUALITY HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE-LEE SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH, MSW, MPH
Authorized Official - Phone:510-444-4300
Mailing Address - Street 1:405 14TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2715
Mailing Address - Country:US
Mailing Address - Phone:510-444-4300
Mailing Address - Fax:510-444-4459
Practice Address - Street 1:10850 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-5266
Practice Address - Country:US
Practice Address - Phone:510-843-6194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000170261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAYD000300OtherMEDI-CAL PROVIDER NUMBER
CABT882AMedicare PIN