Provider Demographics
NPI:1972149748
Name:BAY AREA NEUROINTENSIVISTS INC
Entity type:Organization
Organization Name:BAY AREA NEUROINTENSIVISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOUSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-336-6262
Mailing Address - Street 1:PO BOX 923066
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91392-3066
Mailing Address - Country:US
Mailing Address - Phone:818-366-6262
Mailing Address - Fax:747-253-7676
Practice Address - Street 1:3066 DEER MEADOW DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-2135
Practice Address - Country:US
Practice Address - Phone:818-336-6262
Practice Address - Fax:747-253-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty