| Bayside Medical Group, Inc | |
|
5720 Stoneridge Mall Rd Suite 240 Pleasanton CA 94588-2828 | |
| (925) 463-1234 | |
| (925) 463-9599 |
| Full Name | Bayside Medical Group, Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 5720 Stoneridge Mall Rd, Pleasanton, California |
| Authorized Official Name and Position | Budd Norman Shenkin (OWNER/PRESIDENT) |
| Authorized Official Contact | 9255872505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayside Medical Group, Inc 11875 Dublin Blvd Suite C140 Dublin CA 94568-2843 Ph: (925) 587-2505 | Bayside Medical Group, Inc 5720 Stoneridge Mall Rd Suite 240 Pleasanton CA 94588-2828 Ph: (925) 463-1234 |
| NPI Number | 1689633240 |
|---|---|
| Provider Enumeration Date | 03/22/2006 |
| Last Update Date | 06/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689633240 | NPI | - | NPPES |
| ZZZ06346Z | Other | CA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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