Provider Demographics
NPI:1952384133
Name:BAY AREA CARDIOLOGY MEDICAL GROUP
Entity Type:Organization
Organization Name:BAY AREA CARDIOLOGY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOSNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-734-0336
Mailing Address - Street 1:5565 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4001
Mailing Address - Country:US
Mailing Address - Phone:925-734-0336
Mailing Address - Fax:925-734-0175
Practice Address - Street 1:5565 W LAS POSITAS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4001
Practice Address - Country:US
Practice Address - Phone:925-734-0336
Practice Address - Fax:925-734-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0040842Medicaid
CAZZZ29767ZMedicare PIN