Mark Bazalgette, M.D., Inc.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

A46290 Issued in CA

Legal business name

MARK BAZALGETTE, M.D., INC.

Practice address

1300 S Eliseo Dr
Suite 203
Greenbrae, CA 94904-2023

Phone

(415) 461-3300

Fax

(415) 461-2934

NPI assigned

Sep 22, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Pardini

Title

Practice Administrator

Phone

(415) 461-3300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1629386867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR",
            "address_2": "SUITE 203",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042023",
            "telephone_number": "415-461-3300",
            "fax_number": "415-461-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S ELISEO DR",
            "address_2": "SUITE 203",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949042023",
            "telephone_number": "415-461-3300",
            "fax_number": "415-461-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK BAZALGETTE, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "PARDINI",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "415-461-3300",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A46290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.