Provider Demographics
NPI:1144945544
Name:BG MEDICAL, INC
Entity type:Organization
Organization Name:BG MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, PHD, MBA, OCS
Authorized Official - Phone:415-847-7147
Mailing Address - Street 1:ROBERT BAKER
Mailing Address - Street 2:1137 ESSEX ST
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-5538
Mailing Address - Country:US
Mailing Address - Phone:415-847-7147
Mailing Address - Fax:
Practice Address - Street 1:239 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8220
Practice Address - Country:US
Practice Address - Phone:415-847-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty