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Organization

BAY AREA PEDIATRIC MEDICAL GROUP INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA OCONNELL (MANAGER BUSINESS OFFICE)
(650) 994-1800
Entity
Organization

Contact information

Practice address
1500 SOUTHGATE AVE STE 213, DALY CITY, CA 94015-2231
(650) 994-1800
(650) 994-1888
Mailing address
123 S SAN MATEO DR, SAN MATEO, CA 94401-3804
(650) 343-4200

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0081923
CA
Enumeration date
04/22/2008
Last updated
04/22/2008
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