Bay Area Surgical Associates, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BAY AREA SURGICAL ASSOCIATES, LLC

Practice address

1599 Tara Hills Drive
Pinole, CA 94564

Phone

(510) 724-6549

Fax

(510) 724-6591

NPI assigned

Oct 4, 2018

Organization subpart

No

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

Authorized official

Name

Teodoro Nissen, MD

Title

Owner/President

Phone

(510) 724-6549

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1831664986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1599 TARA HILLS DRIVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-724-6549",
            "fax_number": "510-724-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 TARA HILLS DRIVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "94564",
            "telephone_number": "510-724-6549",
            "fax_number": "510-724-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "NISSEN",
        "authorized_official_first_name": "TEODORO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "510-724-6549",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Pinole, CA
• Providers in Pinole, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; 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.