Organization
BAY AREA SURGICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEODORO NISSEN MD (OWNER/PRESIDENT)
(510) 724-6549
Entity
Organization
Contact information
Practice address
1599 TARA HILLS DRIVE, PINOLE, CA 94564
(510) 724-6549
(510) 724-6591
Mailing address
1599 TARA HILLS DRIVE, PINOLE, CA 94564
(510) 724-6549
(510) 724-6591
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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