# BASS MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BASS MEDICAL GROUP
- **Other names:** Advanced Sports Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790544567
- **Legal business name:** BASS MEDICAL GROUP
- **Authorized official:** PAULA HEWITT (ENROLLMENT COORDINATOR)
- **Authorized official phone:** (925) 378-4512

## Contact information

- **Practice address:** 763 ALTOS OAKS DR STE 2, LOS ALTOS, CA 94024-5400
- **Practice address phone:** (408) 356-0444
- **Practice address fax:** (408) 358-5125
- **Mailing address:** 2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
- **Mailing address phone:** (925) 627-3424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/15/2024
- **Last updated:** 03/15/2024