- Enrollment id
- O20040825001583
- Enrollment state
- CA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1255381547
- Multiple npi flag
- N
- Ccn
- 051508
- Associate id
- 4587638325
- Organization name
- BY THE BAY HEALTH
- Incorporation date
- 1982-06-13
- Incorporation state
- CA
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 17 E SIR FRANCIS DRAKE BLVD
- City
- LARKSPUR
- State
- CA
- Zip code
- 949391727