SAN LUCAS PEDIATRIC, INC. (NPI# 1073870283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073870283 |
| Entity Type | Organization |
| Organization Name | SAN LUCAS PEDIATRIC, INC. |
| Practice Address |
4100 E Commerce Way Ste 100 Sacramento CA 95834-9501 |
| Practice Telephone | 9165759090 |
| Practice Fax Number | 9165759099 |
| Mailing Telephone | 9165759090 |
| Mailing Fax Number | 9165759099 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |
| Authorized Official Name | DR. MANUEL A. AREVALO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9165759090 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A62749 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4100 E COMMERCE WAY STE 100 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95834-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720632540 | Frishta Osmanzada | Family Medicine | 4100 E Commerce Way Ste 100, Sacramento, CA 95834-9501 | 2019-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871085209 | Yen T Tran | Student in an Organized Health Care Education/Training Program | 3810 Rosin Ct Suite 170, Sacramento, CA 95834 | 2018-06-01 |
| 1326557620 | Mariah N Calpo | Registered Nurse | 601 North Market, Sacramento, CA 95834 | 2017-09-29 |
| 1710400700 | Rose Medical Transportation | Driver | 4330 Natomas Central Dr, Sacramento, CA 95834 | 2017-07-20 |
| 1801319066 | Caitlin Janae Lluen | Physical Medicine & Rehabilitation | 1948 Del Paso Road Suite 135, Sacramento, CA 95834 | 2017-07-19 |
| 1083152169 | Irene Enriquez Ramos | Social Worker | 3627 Broadland Street, Sacramento, CA 95834 | 2017-02-08 |
| 1609322973 | Zachary Estrada | Student in an Organized Health Care Education/Training Program | 3780 Rosic Court, Ste 130, Sacramento, CA 95834 | 2016-08-28 |
| 1104287465 | Mark David Levine, Mbr | Psychiatry & Neurology | 3835 N. Freeway Blvd., Suite 100, Sacramento, CA 95834 | 2016-03-15 |
| 1376902767 | Peter Yang | Case Manager/Care Coordinator | 3870 Rosin Court Ste 130, Sacramento, CA 95834 | 2016-02-15 |
| 1346615739 | Renee Joyce Eckley Reinhardt | Nurse Practitioner | 4100 E Commerce Way Suite 100, Sacramento, CA 95834 | 2015-12-10 |
| 1558779454 | Hanh Tran I | Pharmacist | 3769 Broadland St, Sacramento, CA 95834 | 2014-07-24 |
| Find all providers in zip 95834 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374904 | Ollie Health Medical Group, Inc. | Pediatrics | 9700 Business Park Dr Ste 406, Sacramento, CA 95827-1718 | 2020-04-14 |
| 1093353195 | East Sacramento Pediatric Medical Group Inc | Pediatrics | 5030 J St Ste 301, Sacramento, CA 95819-3800 | 2019-12-19 |
| 1992206544 | Brittany Michelle Mcgregor | Pediatrics | 7237 E Southgate Dr Ste A, Sacramento, CA 95823-2637 | 2018-02-27 |
| 1528440708 | Adrienne Hoyt-austin | Pediatrics | 2103 Stockton Blvd, Sacramento, CA 95817-1354 | 2015-06-23 |
| 1043618689 | Zachary Chaffin | Pediatrics | 2516 Stockton Blvd Ste 216, Sacramento, CA 95817-2208 | 2014-12-14 |
| 1316363104 | Howard N Futerman | Pediatrics | 1618 Alhambra Blvd Unit 160546, Sacramento, CA 95816-7622 | 2014-03-17 |
| 1063755932 | Joan Manansala Villaflor | Pediatrics | 7501 Hospital Dr Ste 203, Sacramento, CA 95823-5405 | 2013-03-29 |
| 1972847747 | Lauren E Wilson | Pediatrics | 425 University Avenue, Suite 200, Sacramento, CA 95825 | 2012-11-19 |
| 1982954103 | Virgina Lee | Pediatrics | 1111 Exposition Blvd # 700, Suite 102, Sacramento, CA 95815-4314 | 2012-09-14 |
| 1508113390 | Garrett Hau Sheng | Pediatrics | 1625 Stockton Blvd Ste 106, Sacramento, CA 95816-7098 | 2012-08-10 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95834 |
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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.