Organization Name: | BAYSIDE UROLOGY MEDICAL GROUP INC |
NPI Number: | 1164536579 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL B. HUNTING (OWNER) |
Mailing Address: | 450 4th Ave Ste 303 Chula Vista |
State: | CA US |
Postal Code: | 919104429 |
Phone Number: | 6194200201 |
Fax Number: | 6194257795 |
NPI Enumeration Date: | 08/19/2006 |
NPI Last Update Date: | 05/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |