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Organization
BASS MEDICAL GROUP
Active
Organization
BASS MEDICAL GROUP
Active
Parent organization
BASS MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BASS MEDICAL GROUP
Authorized official
RAJIV NAGESETTY MD (AUTHORIZED OFFICIAL)
(925) 932-6330
Entity
Organization
Contact information
Practice address
2 FIFER AVE STE 130, CORTE MADERA, CA 94925-1174
(925) 287-1256
(925) 287-0913
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
11/18/2024
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