Organization
BASS MEDICAL GROUP
Active
Other names
BASS Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE A POTTER (CREDENTIALING MANAGER)
(925) 948-8143
Entity
Organization
Contact information
Practice address
575 LENNON LN, WALNUT CREEK, CA 94598-2443
(925) 948-8143
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 948-8143
(925) 215-4540
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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