PENINSULA MEDICAL GROUP (NPI# 1376671206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376671206 |
| Entity Type | Organization |
| Organization Name | PENINSULA MEDICAL GROUP |
| Other Organization Name | NONE |
| Practice Address |
1720 El Camino Real Ste 145 Burlingame CA 94010-3224 |
| Practice Telephone | 6506928804 |
| Practice Fax Number | 6506928805 |
| Mailing Telephone | 6506928804 |
| Mailing Fax Number | 6506928805 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2008-03-10 |
| Authorized Official Name | DR. SPENCER TIMOTHY LOWE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6506928804 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A440070 | CA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| none | Other Name - Individual/Organization |
| Street Address |
1720 EL CAMINO REAL STE 145 |
| City | BURLINGAME |
| State | CA |
| Zip Code | 94010-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861486359 | Lisa A. Frey | Nurse Practitioner | 1720 El Camino Real, Suite 130, Burlingame, CA 94010-3224 | 2005-09-10 |
| 1922462431 | Sutter Bay Hospitals | Custodial Care Facility | 1720 El Camino Real, Suite 10, Burlingame, CA 94010-3224 | 2016-04-11 |
| 1801264874 | Lillian Nelson | Nurse Practitioner | 1720 El Camino Real, Burlingame, CA 94010-3224 | 2015-09-08 |
| 1164763231 | Anne Thai Md, A Professional Corporation | Internal Medicine | 1720 El Camino Real, Suite Number 155, Burlingame, CA 94010-3224 | 2013-03-14 |
| 1720352636 | Aaron M. Roland | Family Medicine | 1720 El Camino Real, 130, Burlingame, CA 94010-3224 | 2012-02-24 |
| 1861765901 | Victor Liu | Specialist | 1720 El Camino Real, Suite 200, Burlingame, CA 94010-3224 | 2012-02-21 |
| 1689942062 | Howard A Cohen Md, Inc | Specialist | 1720 El Camino Real, Ste 210, Burlingame, CA 94010-3224 | 2011-12-13 |
| 1902173388 | Peggy Zeng | Optometrist | 1720 El Camino Real, Suite 225, Burlingame, CA 94010-3224 | 2011-11-29 |
| 1548566177 | Aditi Chandra | Internal Medicine | 1720 El Camino Real, Ste 160, Burlingame, CA 94010-3224 | 2011-01-29 |
| 1548583651 | Peninsula Endoscopy Center LLC | Clinic/Center | 1720 El Camino Real, Suite 100, Burlingame, CA 94010-3224 | 2010-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071850 | Jilla Lavian | Social Worker | 1240 Lakeview Drive, San Mateo, CA 94010 | 2020-07-23 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1184182248 | Primrose Healing and Wellness, Inc. | Marriage & Family Therapist | 405 Primrose Rd, #320, Burlingame, CA 94010 | 2019-03-07 |
| 1720508724 | Monazza Chaudhry | Pharmacist | 1828 El Camino Real #104, Burlingame, CA 94010 | 2017-06-21 |
| 1861804007 | Heidi Platt | Counselor | 826 Mahler Road, Burlingame, CA 94010 | 2014-05-22 |
| 1144662685 | Scarlett M Reyes | Counselor | 1818 Gilbreth Road, Suite 230, Womens Recovery Association, Burlingame, CA 94010 | 2013-07-25 |
| 1760821979 | Elliot Naidus | Internal Medicine | 1720 El Camino Real Ste 150, Burlingame, CA 94010 | 2013-06-20 |
| 1831430651 | Huddleston Care, LLC | In Home Supportive Care | 1364 Drake Avenue, Burlingame, CA 94010 | 2013-03-04 |
| 1891070843 | Linda Susan Notario | Pharmacist | 260 El Camino Raal, Burlingame, CA 94010 | 2011-10-20 |
| 1063794006 | Tram Anh Le | Pharmacist | 260 N El Camino Real, Burlingame, CA 94010 | 2011-09-15 |
| Find all providers in zip 94010 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831351295 | Healthy Horizons Lactation Services | Specialist | 720 Howard Ave, Burlingame, CA 94010-3005 | 2008-06-27 |
| 1023134749 | Michael H Girolami Md A Medical Corporation | Specialist | 1750 El Camino Real #11, Burlingame, CA 94010 | 2007-03-22 |
| 1801913306 | Arnold W Goldschlager Md Medical Corporation | Specialist | 1750 El Camino Real Suite 11, Burlingame, CA 94010 | 2007-03-22 |
| 1427142330 | Joy Ying Zhou | Specialist | 1750 El Camino Real Ste 102, Burlingame, CA 94010-3210 | 2006-10-03 |
| 1598858177 | Debra Shapiro | Specialist | 1720 El Camino Real Ste 120, Burlingame, CA 94010-3225 | 2006-10-02 |
| 1497788855 | Charles Nordlinger | Specialist | 1144 Cambridge Rd, Burlingame, CA 94010-3305 | 2006-07-09 |
| 1811499395 | Jenell Marquis | Specialist | 1633 Bayshore Hwy Ste 155, Burlingame, CA 94010-1515 | 2018-03-01 |
| 1114368149 | Tripti Mahendra | Specialist | 1818 Gilbreth Rd, Suite 230, Burlingame, CA 94010-1225 | 2013-07-05 |
| 1861765901 | Victor Liu | Specialist | 1720 El Camino Real, Suite 200, Burlingame, CA 94010-3224 | 2012-02-21 |
| 1093088106 | Alla Skalnyi M.d. Inc. A Professional Corporation | Specialist | 1720 El Camino Real Ste 145, Burlingame, CA 94010-3231 | 2012-02-21 |
| Find all providers in BURLINGAME | ||||
| City | BURLINGAME |
| Zip Code | 94010 |
Please comment or provide details below to improve the information on PENINSULA MEDICAL GROUP.
| 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.