Organization Active NPI

William Bao, MD Inc

  • Internal Medicine Physician
  • City of Industry, CA
National Provider Identifier
1477639789
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WILLIAM BAO, MD INC
Practice address
17595 Almahurst St Ste 202
City of Industry, CA 91748-1799
Phone
(626) 581-4990
Fax
(626) 581-4011
NPI assigned
Oct 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William Bao, M.D.
Title
Provider/President
Phone
(626) 581-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

17595 Almahurst St Ste 202
City of Industry, CA 91748-1799

Mailing address

17595 Almahurst St Ste 202
City of Industry, CA 91748-1799
Phone (626) 581-4990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110510000813 CA Part B Supplier - Clinic/Group Practice 4981880804 Receives reassigned benefits from 1 practitioner
Practice locations: City of Industry, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1009528William Bao MD Inc17595 Almahurst St Suite 202, City of Industry, CA 91748Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory

Locations

17595 Almahurst St
Ste 202
City of Industry, CA 91748
Phone (626) 581-4990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477639789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17595 ALMAHURST ST STE 202",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481799",
            "telephone_number": "626-581-4990",
            "fax_number": "626-581-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17595 ALMAHURST ST STE 202",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917481799",
            "telephone_number": "626-581-4990",
            "fax_number": "626-581-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM BAO, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PROVIDER/PRESIDENT",
        "authorized_official_telephone_number": "626-581-4990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in City of Industry, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.