Provider Demographics
NPI:1265513360
Name:NORTHBAY NEONATOLOGY ASSOCIATES, INC
Entity type:Organization
Organization Name:NORTHBAY NEONATOLOGY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-429-6968
Mailing Address - Street 1:1860 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 145
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3590
Mailing Address - Country:US
Mailing Address - Phone:707-429-6968
Mailing Address - Fax:707-429-6906
Practice Address - Street 1:SUTTER SOLANO MEDICAL CENTER
Practice Address - Street 2:300 HOSPITAL DRIVE
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2594
Practice Address - Country:US
Practice Address - Phone:707-554-5102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ43333ZOtherBLUE SHIELD
CAGR0040030Medicaid
CAZZZ43333ZOtherBLUE SHIELD