Organization
BAY AREA PEDIATRIC PULMONARY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN ANN HARDY M.D. (CEO/PRESIDENT)
(510) 428-3885
Entity
Organization
Contact information
Practice address
747 52ND ST, SUITE 5409, OAKLAND, CA 94609-1809
(510) 428-3305
(510) 597-7154
Mailing address
747 52ND ST, SUITE 5409, OAKLAND, CA 94609-1809
(510) 428-3305
(510) 597-7154
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0085560
—
CA
05
—
GR0085561
—
CA
01
—
ZZZ60448Z
BLUE SHIELD PROVIDER NUMB
CA
01
—
ZZZ60449Z
BLUE SHIELD PROVIDER NUMB
CA
01
—
ZZZ64422Z
BLUE SHIELD PROVIDER NUMB
CA
Enumeration date
08/19/2006
Last updated
06/09/2009
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