Organization
BAY AREA RETINA ASSOCIATES, MEDICAL GROUP
Active
Parent organization
BAY AREA RETINA ASSOCIATES, MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAY AREA RETINA ASSOCIATES, MEDICAL GROUP
Authorized official
AGNES MERCADO CRCS (DIRECTOR OF REVENUE CYCLE)
(925) 265-8324
Entity
Organization
Contact information
Practice address
1460 N CAMINO ALTO STE 206, VALLEJO, CA 94589-2567
(707) 552-9596
(707) 552-9599
Mailing address
365 LENNON LN STE 250, WALNUT CREEK, CA 94598-5915
(925) 265-8324
(925) 522-8658
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0030670
—
CA
05
—
GR0030671
—
CA
Enumeration date
04/15/2009
Last updated
05/23/2021
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