# BAYCHILDREN'S MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497144257
- **Authorized official:** CAROLYN APPENZELLER RN, MSN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (415) 476-7220

## Contact information

- **Practice address:** 6475 CHRISTIE AVE, SUITE 300, EMERYVILLE, CA 94608-1095
- **Practice address phone:** (415) 476-7220
- **Mailing address:** 6475 CHRISTIE AVE, SUITE 300, EMERYVILLE, CA 94608-1095
- **Mailing address phone:** (415) 476-7220
- **Mailing address fax:** (415) 353-8200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | — |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | — |
| 208M00000X | Hospitalist Physician | — | — | — |

## Other

- **Enumeration date:** 01/16/2015
- **Last updated:** 07/14/2015