Provider Demographics
NPI:1336536283
Name:BAY AREA CONSULTING TELEMED LLC
Entity Type:Organization
Organization Name:BAY AREA CONSULTING TELEMED LLC
Other - Org Name:BAC TELEMED LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-385-4223
Mailing Address - Street 1:2210 ASHLEY OAKS CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6404
Mailing Address - Country:US
Mailing Address - Phone:813-368-3586
Mailing Address - Fax:888-981-8070
Practice Address - Street 1:2210 ASHLEY OAKS CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6404
Practice Address - Country:US
Practice Address - Phone:813-368-3586
Practice Address - Fax:888-981-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management