Organization
BASS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INEZ WONDEH (CEO)
(925) 948-8143
Entity
Organization
Contact information
Practice address
390 N WIGET LN STE 100, WALNUT CREEK, CA 94598-2450
(925) 944-0110
(925) 944-0960
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 948-8143
(925) 627-3560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A42343
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
A42343
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7360010001
NSC MEDICARE
—
Enumeration date
11/10/2014
Last updated
03/09/2026
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