Organization
BAY VALLEY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW J BURDUSIS (MANAGER OF INFORMATION SYSTEMS)
(510) 785-5000
Entity
Organization
Contact information
Practice address
27212 CALAROGA AVE, HAYWARD, CA 94545-4339
(510) 785-5000
Mailing address
27212 CALAROGA AVE, HAYWARD, CA 94545-4339
(510) 785-5000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRE00330
MEDICAL PROVIDER NUMBER
CA
Enumeration date
03/24/2009
Last updated
03/24/2009
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