PALO ALTO PERFUSION SERVICE (NPI# 1124630900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124630900 |
| Entity Type | Organization |
| Organization Name | PALO ALTO PERFUSION SERVICE |
| Practice Address |
3801 Miranda Ave Palo Alto CA 94304-1207 |
| Mailing Address |
2825 Mauricia Ave Santa Clara CA 95051-6857 |
| Practice Telephone | 4082025609 |
| Mailing Telephone | 4082025609 |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2020-08-21 |
| Authorized Official Name | MRS. TANYA L BLODGET (PRESIDENT AND CHIEF PERFUSIONIST) |
| Authorized Official Telephone | 4082025609 |
| Authorized Official Credential | CCP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 242T00000X | Perfusionist | Technologists, Technicians & Other Technical Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PALO ALTO PERFUSION SERVICES INC | 11800 Santa Ana Rd, Atascadero, CA 93422-7727 |
| Street Address |
3801 MIRANDA AVE |
| City | PALO ALTO |
| State | CA |
| Zip Code | 94304-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405449 | John Paul Lavelle | Urology | 3801 Miranda Ave, B3-117 Bldg 100 Urology (#112), Palo Alto, CA 94304-1207 | 2005-05-27 |
| 1437750619 | Ashley Ando | Respiratory Therapist, Registered | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-11-04 |
| 1265032783 | Jim Le | Occupational Therapist | 3801 Miranda Ave, Palo Alto, CA 94304-1290 | 2020-10-26 |
| 1497354484 | Laura Renee Zimmerman | Registered Nurse | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-10-21 |
| 1891300810 | Clark Dan Ma | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-09-15 |
| 1790397362 | Gihun Kim | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-08-17 |
| 1750993309 | Jessica Tran | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-08-17 |
| 1083226500 | Danielle Jean Fox | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1290 | 2020-08-17 |
| 1346851078 | Alice Lin | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-08-14 |
| 1164030573 | Isabelle Beatrice Wong | Pharmacist | 3801 Miranda Ave, Palo Alto, CA 94304-1207 | 2020-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170611 | Richard Engdahl | Specialist/Technologist, Other | 820 Quarry Road, Mc1078 Hf006, Palo Alo, CA 94304 | 2020-07-04 |
| 1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
| 1033738521 | Perry Seo Choi | Student in an Organized Health Care Education/Training Program | Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 | 2020-04-14 |
| 1073150355 | Tara Mcdermott | Nurse Practitioner | 500 Pasteur Drive, Cardiovascular Intensive Care Unit, Palo Alto, CA 94304 | 2019-12-05 |
| 1811542723 | Mark Henry Chubb | Pediatrics | Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94304 | 2019-08-07 |
| 1194285114 | Cora Steindl | Nurse Practitioner | 300 Pasteur Drive Rm H2512, Stanford, CA 94304 | 2019-03-25 |
| 1407333057 | Deborah Menet Landi | Social Worker | Lucile Packard Children's Hospital Stanford, 725 Welch, Mc 5933, Palo Alto, CA 94304 | 2018-07-26 |
| 1982100798 | Jonathan Hootman | Student in an Organized Health Care Education/Training Program | 900 Quarry Road Extension, Palo Alto, CA 94304 | 2018-04-02 |
| 1093234254 | Adam C Maclellan | Psychiatry & Neurology | Stanford Stroke Center, 780 Welch Road, Suite 350, Palo Alto, CA 94304 | 2017-09-19 |
| 1194248153 | Chanel Beaudoin Cloutier | Plastic Surgery | 770 Welch Road, Suite 400, Palo Alto, CA 94304 | 2017-07-21 |
| Find all providers in zip 94304 | ||||
| Taxonomy Code | 242T00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Perfusionist |
| A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. |
| Notes: Source: Health Professions Career and Education Directory, American Medical Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265900609 | Juan Carlos Tud | Perfusionist | 250 Fernando Ave, Palo Alto, CA 94306-2814 | 2018-11-04 |
| 1972717965 | Virginia Heitman Diamond | Perfusionist | 426 Palo Alto Ave, Palo Alto, CA 94301-1217 | 2007-05-09 |
| 1346460433 | Robert Martin Bernstein | Perfusionist | 3833 Park Blvd, Apt #1, Palo Alto, CA 94306-3490 | 2007-04-30 |
| 1205241452 | Pacific Life Lines, Inc | Perfusionist | 300 Pasteur Dr, Palo Alto, CA 94305-2200 | 2014-06-26 |
| 1619382983 | Pacific Life Lines, Inc. | Perfusionist | 300 Pasteur Dr, Palo Alto, CA 94305-2200 | 2014-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518574599 | Jonathan Persa | Perfusionist | 500 Race St Apt 4204, San Jose, CA 95126-5155 | 2020-09-24 |
| 1215551825 | Samantha Rhymer | Perfusionist | 2280 W El Camino Real Apt 3117, Mountain View, CA 94040-6231 | 2020-05-31 |
| 1912537770 | Ecmo Prn LLC | Perfusionist | 1246 Mission Rd, South San Francisco, CA 94080-1212 | 2020-01-21 |
| 1174082424 | Tun Win | Perfusionist | 580 N Wilma Ave Ste F, Ripon, CA 95366-9514 | 2019-03-17 |
| 1801318431 | Kevin Saiki | Perfusionist | 27729 Willow Trl, Escondido, CA 92026-7327 | 2017-07-14 |
| 1528597234 | Samantha Kollmann | Perfusionist | 700 Bair Island Rd # 230-204, Redwood City, CA 94063-2872 | 2017-06-06 |
| 1023546991 | Vina Nguyen | Perfusionist | 105 Fairchild Dr, Mountain View, CA 94043-2014 | 2017-05-23 |
| 1285175679 | Monette Thiele | Perfusionist | 668 Alice St, Monterey, CA 93940-2002 | 2017-03-17 |
| 1073055521 | Brian Haack | Perfusionist | 4638 Pepperwood Ave, Long Beach, CA 90808-1071 | 2016-11-15 |
| 1922550664 | Pablo Zubiate | Perfusionist | 13999 Limousin Drive, Chico, CA 95973 | 2016-10-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PALO ALTO PERFUSION SERVICE.
| 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.