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Organization

BAY AREA PAIN MEDICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE KEANEY RN, BSN (PRACTICE MANAGER)
(415) 380-0480
Entity
Organization

Contact information

Practice address
3 HARBOR DR, SUITE 115, SAUSALITO, CA 94965-1454
(415) 380-0480
Mailing address
3 HARBOR DR, SUITE 115, SAUSALITO, CA 94965-1454
(415) 380-0480

Taxonomy

Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
C38406
CA
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
C39226
CA
363LF0000X
Family Nurse Practitioner
11549
CA
364S00000X
Clinical Nurse Specialist
370895
CA

Other

Enumeration date
03/12/2007
Last updated
04/23/2015
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