Provider Demographics
NPI:1447439583
Name:BAY EYE MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:BAY EYE MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REX
Authorized Official - Middle Name:C
Authorized Official - Last Name:HSEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-761-5488
Mailing Address - Street 1:1665 DOMINICAN WAY
Mailing Address - Street 2:SUITE 124
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1528
Mailing Address - Country:US
Mailing Address - Phone:831-475-7012
Mailing Address - Fax:831-475-1512
Practice Address - Street 1:65 ASPEN WAY
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-6054
Practice Address - Country:US
Practice Address - Phone:831-761-5488
Practice Address - Fax:831-761-5487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21217ZMedicare PIN
CA0380730002Medicare NSC