Organization
BASS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INEZ WONDEH (CEO)
(925) 378-4512
Entity
Organization
Contact information
Practice address
2250 MORELLO AVE, PLEASANT HILL, CA 94523-1860
(925) 287-1256
(925) 287-0913
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 627-3424
(925) 627-3560
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7360010010
NSC MEDICARE
—
Enumeration date
03/07/2016
Last updated
10/18/2023
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