Organization
BAY AREA PEDIATRIC GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA OCONNELL (MANAGER BUSINESS OFFICE)
(650) 994-1800
Entity
Organization
Contact information
Practice address
1500 SOUTHGATE AVE STE 213, DALY CITY, CA 94015-2231
(650) 994-1800
(650) 994-1888
Mailing address
57 EL CAMINO REAL, SAN CARLOS, CA 94070-2401
(650) 591-3937
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0081922
—
CA
Enumeration date
04/22/2008
Last updated
04/22/2008
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