Organization
SHADELANDS ADVANCED ENDOSCOPY INSTITUTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
498 N WIGET LN, WALNUT CREEK, CA 94598-2408
(925) 933-3600
(925) 933-7900
Mailing address
498 N WIGET LN, WALNUT CREEK, CA 94598-2408
(925) 948-8143
(925) 215-4540
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
02/10/2026
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