Basic Information
| Provider Information | |||||||||
| NPI: | 1952384133 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BAY AREA CARDIOLOGY MEDICAL GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5565 W LAS POSITAS BLVD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945884001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257340336 | ||||||||
| FaxNumber: | 9257340175 | ||||||||
| Practice Location | |||||||||
| Address1: | 5565 W LAS POSITAS BLVD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945884001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257340336 | ||||||||
| FaxNumber: | 9257340175 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 11/03/2008 | ||||||||
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| AuthorizedOfficialLastName: | HOSNY | ||||||||
| AuthorizedOfficialFirstName: | AYMAN | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 9257340336 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | GR0040842 | 05 | CA | MEDICAID |