MR. CHARLES WILLIAM CROUSE (NPI# 1093846479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093846479 |
| Entity Type | Individual |
| Full Name | MR. CHARLES WILLIAM CROUSE |
| Credential | CRT |
| Practice Address |
801 Maple St 801 Maple Street San Mateo CA 94402-2302 |
| Mailing Address |
801 Maple St 801 Maple Streett San Mateo CA 94402-2302 |
| Practice Telephone | 6503471880 |
| Mailing Telephone | 6503471880 |
| Mailing Fax Number | 6503428379 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | RHT3605 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | ZZZ31682Z | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851377857 | Charles David Crouse II | Otolaryngology | 1524 Apperson Dr, Salem, VA 24153-7219 | 2005-12-21 |
| 1134644800 | Charles Crouse | Nurse Anesthetist, Certified Registered | 601 E Rollins St, Orlando, FL 32803-1248 | 2017-08-03 |
| 1518131549 | Charles Edwin Crouse IIi | Orthopaedic Surgery | 1350 Flemingsburg Rd, Morehead, KY 40351-1810 | 2008-04-22 |
| Street Address |
801 MAPLE ST 801 MAPLE STREET |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396920047 | Home Portable X-ray | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 30 So El Camino Real, Suite 109, San Mateo, CA 94401 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629696497 | Iscan Medical Imaging, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 21822 Sherman Way Ste 201, Canoga Park, CA 91303-1938 | 2020-07-08 |
| 1518582014 | Pdi Health Ca LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3415 South Sepulveda Blvd Ste 1100, Los Angeles, CA 90034 | 2020-06-10 |
| 1790314151 | Jem Imaging Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 359 Churchill Pl, Gilroy, CA 95020-6738 | 2020-04-07 |
| 1427695352 | Quality Care Diagnostic Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 11900 Avalon Blvd Ste 101, Los Angeles, CA 90061-2867 | 2019-12-10 |
| 1851940431 | X-ray Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 6450 Bellingham Ave Ste F, North Hollywood, CA 91606-1429 | 2019-09-06 |
| 1063074730 | Better Life United Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4100 Easton Dr Ste 12, Bakersfield, CA 93309-9418 | 2019-07-02 |
| 1679134118 | Sd Xray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3220 S Brea Canyon Rd Ste B, Diamond Bar, CA 91765-3481 | 2019-06-25 |
| 1114583549 | Ruahrena Corporation | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3053 West Olympic Boulevard, Suite 301, Los Angeles, CA 90006 | 2019-05-10 |
| 1457816712 | Pmdtc, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 23297 S Pointe Dr Ste 120, Laguna Hills, CA 92653-1491 | 2019-01-31 |
| 1083188767 | Mabel Imaging Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 356 E Olive Ave Ste 111, Burbank, CA 91502-1260 | 2019-01-16 |
| Find all providers with the same taxonomy | ||||
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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.