PERMANENTE MEDICAL GROUP INC (NPI# 1073606299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073606299 |
| Entity Type | Organization |
| Organization Name | PERMANENTE MEDICAL GROUP INC |
| Practice Address |
710 Lawrence Expressway Santa Clara CA 95051-5173 |
| Mailing Address |
1950 Franklin St 18th Floor Tpmg Financial Mgmt Oakland CA 94612-5103 |
| Practice Telephone | 4088511000 |
| Mailing Telephone | 5109871000 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | MS. PATRICIA T WEST (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5102957207 |
| Is Organization Subpart | Y |
| Parent Organization Name | PERMANENTE MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GROO1572P | 05 | |
| CA | GR001572U | 05 | |
| CA | GR001572T | 05 | |
| CA | ZZZ74979Z | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841373800 | Permanente Medical Group Inc | Anesthesiology | 2238 Geary, San Francisco, CA 94116-3416 | 2006-10-23 |
| 1235226531 | Permanente Medical Group Inc | Surgery | 901 Nevin, Richmond, CA 94801-3143 | 2006-10-06 |
| 1336222397 | Permanente Medical Group Inc | Anesthesiology | 975 Sereno Drive, Vallejo, CA 94589-2441 | 2006-10-23 |
| 1639252604 | Permanente Medical Group Inc | Anesthesiology | 1190 Veterans Blvd, Redwood City, CA 94063-2037 | 2006-10-23 |
| 1548343510 | Permanente Medical Group Inc | Surgery | 7373 West Lane, Stockton, CA 95210-3377 | 2006-10-23 |
| Street Address |
710 LAWRENCE EXPRESSWAY |
| City | SANTA CLARA |
| State | CA |
| Zip Code | 95051-5173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750389250 | Hyma Tanikella Vempaty | Internal Medicine | 710 Lawrence Expressway, Kaiser Permanente, Santa Clara, CA 95051 | 2005-07-08 |
| 1326658089 | Andrea King | Pharmacist | 710 Lawrence Expressway, Mob 3rd Floor, Dept 362, Santa Clara, CA 95051 | 2020-08-06 |
| 1992323265 | Ashley C Yam | Pharmacist | 710 Lawrence Expressway, 3rd Floor, Department 362, Santa Clara, CA 95051 | 2020-07-13 |
| 1194385419 | Golnoush Golshan | Pharmacist | 710 Lawrence Expressway, 3rd Floor, Dept. 362, Santa Clara, CA 95051 | 2019-06-18 |
| 1629542006 | Beverly Saito Acuna | Respiratory Therapist, Certified | 710 Lawrence Expressway, Pulmonary Department #282 /m2405, Santa Clara, CA 95051 | 2019-01-18 |
| 1891265427 | Sarah Mcadoo | Respiratory Therapist, Registered | 710 Lawrence Expressway, Santa Clara, CA 95051 | 2018-11-27 |
| 1063941920 | Amanda Do | Clinical Pharmacology | 710 Lawrence Expressway, Mob, 3rd Fl, Dept 362, Santa Clara, CA 95051 | 2017-06-05 |
| 1619409067 | Jessica Marie Ocampo | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expressway, Department 384, Santa Clara, CA 95051 | 2017-04-03 |
| 1265842967 | Merrit Alexis Hoover Koskelo | Student in an Organized Health Care Education/Training Program | 710 Lawrence Expressway, Kaiser Permanente Medical Center, Santa Clara, CA 95051 | 2014-05-02 |
| 1114272812 | Joanne Francisco | Pharmacist | 710 Lawrence Expressway, Dept 362 Kaiser Permanente Santa Clara, Santa Clara, CA 95051 | 2012-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043773690 | Christian Hamm | Pharmacist | Kaiser Permanente Medical Center Santa Clara, Dept 362 (inpatient Pharmacy), 710 Lawrence Expressway, Santa Clara, CA 95051 | 2019-04-10 |
| 1053879692 | Jiaqi Weng | Acupuncturist | 2062 Walsh Ave Suite B2, San Clare, CA 95051 | 2019-03-02 |
| 1699293209 | Leslie Avalos | Massage Therapist | 3530 Lochnivar Ave, Santa Clara, CA 95051 | 2017-09-04 |
| 1831552843 | Miral Neel Patel | Physical Therapist | 2737 Walsh Avenue, Alliance Occupational Medicine, Santa Clara, CA 95051 | 2016-03-29 |
| 1861831117 | Alison Wong | Emergency Medicine | 700 Lawrence Expy Dept 100, Santa Clara, CA 95051 | 2013-06-20 |
| 1073889291 | Brittany Lee Bianchi | Speech-Language Pathologist | 3775 Flora Vista Ave, Apt. 501, Santa Clara, CA 95051 | 2012-04-02 |
| 1124390067 | Karo Isajan | Chiropractor | 5145 Stevens Creek Blvd Ste 130, Santa Clara, CA 95051 | 2012-02-08 |
| 1598054991 | David Phillip Guo | Urology | 710 Lawrence Expy Dept 448, Santa Clara, CA 95051 | 2011-04-06 |
| 1043528573 | Jennifer Hui Young | Chiropractor | 2342 Walsh Ave, Santa Clara, CA 95051 | 2010-09-17 |
| 1386961217 | Assefa Gebremichael | Pharmacist | 1000 Kiely Blvd, #91, Santa Clara, CA 95051 | 2010-05-03 |
| Find all providers in zip 95051 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366853103 | Momina Waqar | Internal Medicine | 710 Lawrence Expy Dept 360, Santa Clara, CA 95051-5173 | 2014-05-14 |
| 1811278682 | Mariya Pelvitski | Internal Medicine | 710 Lawrence Expy Dept 498, Santa Clara, CA 95051-5173 | 2011-09-07 |
| 1568789048 | Richard Anthony Lau | Internal Medicine | 710 Lawrence Expy Dept 140, Santa Clara, CA 95051 | 2010-04-23 |
| 1356581748 | Kavitha Kambham | Internal Medicine | 2233 Lenox Pl, Santa Clara, CA 95054-1385 | 2009-02-25 |
| 1134374275 | Peter K Lee | Internal Medicine | 710 Lawrence Expy Dept 384, Santa Clara, CA 95051-5173 | 2008-11-17 |
| 1003070012 | Uma Devi Kantamuneni | Internal Medicine | 3655 Pruneridge Ave Apt 224, Santa Clara, CA 95051-5948 | 2008-07-18 |
| 1497928360 | Central Medical Center Inc | Internal Medicine | 2344 El Camino Real Ste 105, Santa Clara, CA 95050-4072 | 2008-04-10 |
| 1255525366 | Elisabeth Anna Calvelli | Internal Medicine | 710 Lawrence Expy Dept 260, Kaiser Permanente, Santa Clara, CA 95051-5173 | 2007-08-31 |
| 1700935632 | Ana Milena Ojeda Brittain | Internal Medicine | 700 Lawrence Expressway, Suite P 3502 Hospital Medicine, Santa Clara, CA 95051 | 2007-01-09 |
| 1881762847 | De H Tran | Internal Medicine | 2518 Mission College Blvd, Santa Clara, CA 95054-1239 | 2006-11-30 |
| Find all providers in SANTA CLARA | ||||
| City | SANTA CLARA |
| Zip Code | 95051 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.