Organization
BAY AREA SURGICAL SPECIALISTS, INC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INEZ WONDEH (COO)
(925) 948-8143
Entity
Organization
Contact information
Practice address
911 MORAGA RD STE 101, LAFAYETTE, CA 94549-4591
(925) 962-9120
(925) 962-9122
Mailing address
2637 SHADELANDS DR, WALNUT CREEK, CA 94598-2512
(925) 948-8143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7360010012
NSC MEDICARE
—
Enumeration date
09/12/2016
Last updated
03/09/2018
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