PENINSULA HEAD & NECK SURGERY,INC (NPI# 1134342215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134342215 |
| Entity Type | Organization |
| Organization Name | PENINSULA HEAD & NECK SURGERY,INC |
| Practice Address |
900 Welch Rd Suite 103 Palo Alto CA 94304-1805 |
| Practice Telephone | 6503299100 |
| Practice Fax Number | 6503290626 |
| Mailing Telephone | 6503299100 |
| Mailing Fax Number | 6503290626 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2011-03-03 |
| Authorized Official Name | DR. LEON W LIPSON (PRESIDENT) |
| Authorized Official Telephone | 6503299100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
G124240 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
900 WELCH RD SUITE 103 |
| City | PALO ALTO |
| State | CA |
| Zip Code | 94304-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457355794 | Ami Laws | Internal Medicine | 900 Welch Rd, Suite 103, Palo Alto, CA 94304-1805 | 2005-06-01 |
| 1356837538 | Elizabeth Spiteri | Medical Genetics | 900 Welch Rd, Palo Alto, CA 94304-1805 | 2018-07-10 |
| 1073018081 | Nicole Jean Prendergast | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Palo Alto, CA 94304-1805 | 2018-03-30 |
| 1437665643 | Shana White | Genetic Counselor, MS | 900 Welch Rd, Palo Alto, CA 94304-1805 | 2017-12-26 |
| 1740715853 | Sunny Patel | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304-1805 | 2017-04-26 |
| 1427583533 | Cameron Mozayan | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304 | 2017-04-26 |
| 1417481128 | Bryn Elizabeth Eisfelder | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304-1805 | 2017-04-19 |
| 1952835357 | Daniel Thomas Rogan | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304-1805 | 2017-04-12 |
| 1447783089 | Victor Sadauskas | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304-1805 | 2017-04-11 |
| 1679006274 | Robert Conner Dixon | Student in an Organized Health Care Education/Training Program | 900 Welch Rd, Suite 350, Palo Alto, CA 94304-1805 | 2017-04-10 |
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| 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 | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316176852 | Jason Kyle-ming Chau | Otolaryngology | 801 Welch Rd, Palo Alto, CA 94304-1611 | 2009-07-06 |
| 1760473128 | Alan Gi-lun Cheng | Otolaryngology | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2005-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770041881 | Robotic Brain and Spine Institute Inc | Otolaryngology | 9201 W Sunset Blvd Ste 405, Los Angeles, CA 90069-3705 | 2019-03-07 |
| 1447500269 | Esrafil Abedi Md A Professional Corporation | Otolaryngology | 23961 Calle Magdalena St, 430, Laguna Hills, CA 92653-3685 | 2012-09-19 |
| 1184971194 | Gabriel Gabarain | Otolaryngology | 4646 Brockton Ave Ste 201, Riverside, CA 92506 | 2012-08-08 |
| 1154636769 | Louis G. Brennan | Otolaryngology | 4 Leicester Ct, Laguna Niguel, CA 92677-9380 | 2010-08-09 |
| 1568783470 | Dana Kristopher Petersen | Otolaryngology | 1001 Potrero St, San Francisco General Hospital, San Francisco, CA 94110 | 2010-06-15 |
| 1275784233 | Stephen Wayne Hargett | Otolaryngology | 1200 North State St., Los Angeles, CA 90033 | 2008-10-08 |
| 1568664548 | Geoffrey Arthur Smith | Otolaryngology | 7910 Frost St # 420, San Diego, CA 92123-2771 | 2007-06-03 |
| 1831319326 | Shamit Chopra | Otolaryngology | 2521 Stockton Blvd Ste 7200, Sacramento, CA 95817-2207 | 2007-04-26 |
| 1194941641 | Ronaldo A Ballecer | Otolaryngology | 540 E Herndon Ave Ste 105, Suite 105, Fresno, CA 93720-2993 | 2007-04-17 |
| 1669515862 | Kaniff Cosmetic Medical Center, Inc | Otolaryngology | 631 Fulton Ave, Sacramento, CA 95825-4813 | 2007-02-15 |
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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.