MS. MARY SURDILLA (NPI# 1407197437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407197437 |
| Entity Type | Individual |
| Full Name | MS. MARY SURDILLA |
| Credential | P.A-C |
| Practice Address |
3200 Kearney St Fremont CA 94538-2299 |
| Mailing Address |
325 Distel Cir Los Altos CA 94022-1408 |
| Practice Telephone | 5104982890 |
| Mailing Telephone | 5104982890 |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2020-06-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 15975 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4303 Stevenson Blvd, Fremont, CA 945382645 | 5107546152 | 5106511543 |
| Street Address |
3200 KEARNEY ST |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-2299 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225034556 | Aruna Reddy | Family Medicine | 3200 Kearney St, Fremont, CA 94538-2299 | 2005-06-22 |
| 1528546074 | Phoenix Di Ying | Physician Assistant | 3200 Kearney St, Fremont, CA 94538-2299 | 2018-08-06 |
| 1235625054 | Reetu Nigam | Dietitian, Registered | 3200 Kearney St, Fremont, CA 94538-2299 | 2018-07-04 |
| 1700378460 | Amrit Kaur Bola | Nurse Practitioner | 3200 Kearney St, Fremont, CA 94538 | 2018-05-30 |
| 1154840767 | Rodger Ruby | Family Medicine | 3200 Kearney St, Fremont, CA 94538-2299 | 2017-09-14 |
| 1669908968 | Lena Y Sun | Podiatrist | 3200 Kearney St, Fremont, CA 94538-2299 | 2017-05-04 |
| 1396279964 | Dipal Savla | Pediatrics | 3200 Kearney St, Fremont, CA 94538-2299 | 2017-04-20 |
| 1851823421 | Phuoc Thanh Dinh Vu | Family Medicine | 3200 Kearney St, Fremont, CA 94538-2299 | 2017-04-01 |
| 1215477377 | Erin Hodgson | Dietitian, Registered | 3200 Kearney St, Fremont, CA 94538-2299 | 2017-03-08 |
| 1174071013 | Sarah Monje | Dietitian, Registered | 3200 Kearney St, Fremont, CA 94538-2299 | 2016-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235416710 | Manuel Antonio Hipol | Physician Assistant | 37313 Maple St, Fremont, CA 94536-4848 | 2011-11-10 |
| 1316260839 | Marla D Carlisle | Physician Assistant | 605 Third Avenue, Suite B, Fremont, OH 43420 | 2010-03-11 |
| 1992804587 | Joseph Ray Warren Jr. | Physician Assistant | 109 S Sycamore St, Fremont, NC 27830-8710 | 2006-09-21 |
| 1992761670 | Robert John Estis | Physician Assistant | 39180 Farwell Dr Ste 211, Fremont, CA 94538 | 2006-04-21 |
| 1841265097 | Lisa M Stenvers | Physician Assistant | 2350 N Clarkson St, Fremont, NE 68025-2312 | 2006-02-21 |
| 1427666577 | Sophie Dunnell Ullman | Physician Assistant | 3301 E Elkhorn Dr Ste 100, Fremont, NE 68025-6240 | 2020-07-15 |
| 1962998849 | Sonia S Chahal | Physician Assistant | 39001 Sundale Dr, Fremont, CA 94538-2005 | 2018-07-03 |
| 1831495944 | Carlos Edward Jaramillo | Physician Assistant | 3200 Kearney St, Fremont, CA 94538-2299 | 2011-02-07 |
| 1932405453 | Kimberly N Kurtz | Physician Assistant | 39141 Civic Center Dr, Suite #130, Fremont, CA 94538-5818 | 2011-01-31 |
| 1295952034 | Georgann Gervasi-lyttkens | Physician Assistant | 2333 Mowry Ave, Suite #220, Fremont, CA 94538-1625 | 2007-04-20 |
| Find all providers in FREMONT | ||||
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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.