Basic Information
| Provider Information | |||||||||
| NPI: | 1336117829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST BAY NEPHROLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1498 SOUTHGATE AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DALY CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507554492 | ||||||||
| FaxNumber: | 6507554466 | ||||||||
| Practice Location | |||||||||
| Address1: | 1498 SOUTHGATE AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | DALY CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507554492 | ||||||||
| FaxNumber: | 6507554466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | TSENG | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | NEPHROLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 6057554492 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.