Organization
BAYVIEW GASTROENTEROLOGY MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHADEMI D.O. (PHYSICIAN)
(831) 662-9999
Entity
Organization
Contact information
Practice address
4145 CLARES ST, STE A, CAPITOLA, CA 95010-2053
(831) 662-9999
(831) 662-9998
Mailing address
4145 CLARES ST, STE A, CAPITOLA, CA 95010-2053
(831) 662-9999
(831) 662-9998
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
20A7421
CA
Other
Enumeration date
06/09/2008
Last updated
12/13/2016
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