PERMANENTE MEDICAL GROUP (NPI# 1417308321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417308321 |
| Entity Type | Organization |
| Organization Name | PERMANENTE MEDICAL GROUP |
| Practice Address |
1955 Cowell Blvd Davis CA 95618-6325 |
| Practice Telephone | 5307574157 |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |
| Authorized Official Name | BARRY SCURRAN (DPM) |
| Authorized Official Telephone | 5109874026 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A49994 | CA | Other Service Providers |
| Street Address |
1955 COWELL BLVD |
| City | DAVIS |
| State | CA |
| Zip Code | 95618-6325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164408704 | John M. Chuck | Family Medicine | 1955 Cowell Blvd, Davis, CA 95616-6325 | 2005-12-15 |
| 1053845933 | Linda Leong Lee | Pharmacist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2017-04-17 |
| 1558895698 | Vera Yep | Pharmacist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2017-04-15 |
| 1376077628 | James Buck | Pharmacist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2017-04-13 |
| 1760915938 | Timothy Pia | Pharmacist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2017-04-05 |
| 1699119032 | Allison Rubin Buss | Pediatrics | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2013-04-27 |
| 1477841484 | Wilson Lee | Optometrist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2011-07-12 |
| 1730328469 | Charles Matthew Easton | Pharmacist | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2009-02-19 |
| 1578749396 | Catherine Elizabeth Dycaico | Internal Medicine | 1955 Cowell Blvd, Davis, CA 95618-6325 | 2008-01-10 |
| 1033238605 | Suzanne L. Bier | Obstetrics & Gynecology | 1955 Cowell Blvd, Davis, CA 95616-6325 | 2007-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568013332 | Maria Pilar Alonso Nunez | Social Worker | 2707 Henri Ct, Davis, CA 95618 | 2019-09-24 |
| 1437616349 | Dagon Jones Dds Inc. | Dentist | 2800 5th Street, Suite 100, Davis, CA 95618 | 2019-02-27 |
| 1265938484 | Martel Elizabeth Costa | Nurse Practitioner | 1909 Galileo Ct Ste A, Davis, CA 95618 | 2018-04-05 |
| 1952785644 | Avineet Boparai | Dentist | 4515 Fermi Pl Ste 106, Davis, CA 95618 | 2015-07-13 |
| 1063841096 | Sergio Vicuna Dental Corporation | Dentist | 4515 Fermi Place Suite 106, Davis, CA 95618 | 2013-11-12 |
| 1700103314 | Daren Allen Casagrande | Counselor | 315 Mace Blvd, Davis, CA 95618 | 2010-04-23 |
| 1689802803 | Rocky P.j. Jedick | Emergency Medicine | 2206 Halsey Cir, Davis, CA 95618 | 2009-06-25 |
| 1356463004 | Vincent & Associates | Speech-Language Pathologist | 3560 J Street, Suite 1, Sacramento, CA 95618 | 2007-04-04 |
| 1316075138 | New Life Clinic | Acupuncturist | 1736 Picasso Ave., Suite B, Davis, CA 95618 | 2007-03-01 |
| 1558419622 | Baoping Li | Acupuncturist | 1736 Picasso Ave, Suite B, Davis, CA 95618 | 2007-01-08 |
| Find all providers in zip 95618 | ||||
| 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 |
|---|---|---|---|---|
| 1699982389 | Christinea Marie Bellin | Specialist | 2604 Hartley St, Davis, CA 95616-7632 | 2007-05-16 |
| 1730293309 | Sacramento Heart & Vascular | Specialist | 1111 Kennedy Pl Ste 1, Davis, CA 95616-1266 | 2006-08-19 |
| 1386694404 | Lawrence S Paikoff | Specialist | 1712 Picasso Ave, #c, Davis, CA 95616-0546 | 2006-05-11 |
| 1285619296 | Renuka Lakshminarayanan | Specialist | 3002 Breton Ave, Davis, CA 95616-2706 | 2005-12-13 |
| 1407838782 | Brian Robert Wilson | Specialist | 2020 Sutter Pl Ste 203, Davis, CA 95616-6201 | 2005-11-14 |
| 1962948372 | Elyse Lauren Byrum | Specialist | 212 I St, Davis, CA 95616-4213 | 2017-01-09 |
| 1467906222 | Duane Robinson | Specialist | 1 Shields Ave, School of Vet Med, Uc Davis, Davis, CA 95616-5270 | 2016-08-10 |
| 1669858817 | Davis Urgent Care Inc. | Specialist | 4515 Fermi Pl, Suite 105, Davis, CA 95618-9410 | 2015-08-10 |
| 1891058947 | Stephanie J Lake | Specialist | One Shields Ave, Uc Davis Student Health and Couseling Services, Davis, CA 95616 | 2012-06-22 |
| 1700062916 | Lawrence S Paikoff, Md | Specialist | 1756 Picasso Ave, Ste. #e, Davis, CA 95618-0549 | 2008-01-17 |
| Find all providers in DAVIS | ||||
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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.