Provider Demographics
NPI:1215137633
Name:BAY INFECTIOUS DISEASE
Entity type:Organization
Organization Name:BAY INFECTIOUS DISEASE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YENJEAN
Authorized Official - Middle Name:SYN
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-254-3805
Mailing Address - Street 1:1 COUNTRY CLUB PLZ
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2308
Mailing Address - Country:US
Mailing Address - Phone:925-254-3805
Mailing Address - Fax:925-254-9783
Practice Address - Street 1:1 COUNTRY CLUB PLZ
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2308
Practice Address - Country:US
Practice Address - Phone:925-254-3805
Practice Address - Fax:925-254-9783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01156ZMedicare UPIN