Provider Demographics
NPI:1699986950
Name:BAY AREA OBSTETRICS & GYNECOLOGY
Entity type:Organization
Organization Name:BAY AREA OBSTETRICS & GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ODONOGHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-756-2404
Mailing Address - Street 1:1850 SULLIVAN AVE
Mailing Address - Street 2:550
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2221
Mailing Address - Country:US
Mailing Address - Phone:650-756-2404
Mailing Address - Fax:650-994-9646
Practice Address - Street 1:1850 SULLIVAN AVE
Practice Address - Street 2:550
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2221
Practice Address - Country:US
Practice Address - Phone:650-756-2404
Practice Address - Fax:650-994-9646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ84651ZMedicare UPIN