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Organization
BASS MEDICAL GROUP
Active
Organization
BASS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INEZ C WONDEH (CEO)
(925) 378-0363
Entity
Organization
Contact information
Practice address
221 E HACIENDA AVE STE C, CAMPBELL, CA 95008-6625
(408) 404-4700
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 378-4512
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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