Provider Demographics
NPI:1811460801
Name:BAY ULTRASOUND, LLC
Entity type:Organization
Organization Name:BAY ULTRASOUND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVIER
Authorized Official - Middle Name:DAVON
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:RVS
Authorized Official - Phone:510-859-4178
Mailing Address - Street 1:2738 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2635
Mailing Address - Country:US
Mailing Address - Phone:619-206-5662
Mailing Address - Fax:510-443-1090
Practice Address - Street 1:3155 KEARNEY ST # 109
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2268
Practice Address - Country:US
Practice Address - Phone:510-859-4178
Practice Address - Fax:510-443-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No305S00000XManaged Care OrganizationsPoint of Service