FARALLON INPATIENT MEDICAL GROUP INC (NPI# 1417441080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417441080 |
| Entity Type | Organization |
| Organization Name | FARALLON INPATIENT MEDICAL GROUP INC |
| Other Organization Name | FARALLON MEDICAL GROUP |
| Practice Address |
5176 Hill Rd E Lakeport CA 95453-6300 |
| Mailing Address |
9 Jeffrey Ct Novato CA 94945-1739 |
| Practice Telephone | 7072625000 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |
| Authorized Official Name | CHRISTOPHER VALENTINO (COO) |
| Authorized Official Telephone | 4159989707 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| FARALLON MEDICAL GROUP | Doing Business As Name - Organization |
| Street Address |
5176 HILL RD E |
| City | LAKEPORT |
| State | CA |
| Zip Code | 95453-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023013125 | Myron P. Schneider | Radiology | 5176 Hill Rd E, Dept of Imaging, Lakeport, CA 95453-6300 | 2005-06-15 |
| 1093171522 | California Advanced Imaging Medical Associates, Inc. | Radiology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2016-01-13 |
| 1831597517 | Sutter West Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Modular Building, Lakeport, CA 95453-6300 | 2014-12-12 |
| 1710300504 | California Pacific Pathology Medical Group | Pathology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2014-01-29 |
| 1194068635 | Lake County Anesthesia PC | Anesthesiology | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2013-04-03 |
| 1841541455 | Richelle M Gaiter | Physician Assistant | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2012-09-21 |
| 1023380334 | Kimberley Curtis | Acupuncturist | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2012-02-01 |
| 1770816829 | Sutter Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| 1598098642 | Sutter Bay Hospitals | Medicare Defined Swing Bed Unit | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
| 1700119856 | Sutter West Bay Hospitals | Clinic/Center | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2009-09-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427526847 | Easter Seals Bay Area | Early Intervention Provider Agency | 1950 Parallel Drive, Lakeport, CA 95453 | 2018-11-03 |
| 1285000810 | Lake County Tribal Health Consortium, Inc. | Clinic/Center | 14678 Lakeshore Boulevard, Clearlake, CA 95453 | 2015-08-18 |
| 1942558721 | Lorena A Watson | Nurse Practitioner | 5108 Hill Road East, Lakeport, CA 95453 | 2012-08-27 |
| 1992024657 | Jennifer Stolworthy Smith | Case Manager/Care Coordinator | 991 Parallel Dr. Ste. B, County of Lake, Mental Health, Lakeport, CA 95453 | 2010-05-20 |
| 1376720664 | June Arisa Masato | Marriage & Family Therapist | 1152 S. Main St, Lakeport, CA 95453 | 2008-01-29 |
| 1245417021 | Robert Ryan Taylor Sr. | Physical Therapist | 1285 S Main Street, Lakeport, CA 95453 | 2008-01-24 |
| 1760669618 | Joan Kammerer | Registered Nurse | 922 Bevins Court, Lakeport, CA 95453 | 2008-01-23 |
| 1881878353 | Mary Theresa Mcmillan | Marriage & Family Therapist | 75 Fourth Street, Lakeport, CA 95453 | 2007-12-19 |
| 1922288984 | Robert William Krause | Family Medicine | 755 Eleventh St, Lakeport, CA 95453 | 2007-11-07 |
| 1568683092 | Dan Sleeth | Marriage & Family Therapist | 991 Parallel Dr., Lakeport, CA 95453 | 2007-05-01 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376636597 | Lakeport Emergency Medical Corporation | Emergency Medicine | 5176 Hill Rd E, Lakeport, CA 95453-6357 | 2006-10-02 |
| 1639189715 | Bruce David Deas | Emergency Medicine | 5176 Hill Road E., Lakeport, CA 95453-6300 | 2006-08-09 |
| 1982614061 | Edward M. Fedun | Emergency Medicine | 5176 Hill Road E., Lakeport, CA 95453-6300 | 2006-08-09 |
| 1952332777 | Robert A Shapiro | Emergency Medicine | 5176 Hill Rd E, Lakeport, CA 95453-6300 | 2006-07-06 |
| 1881637023 | Christian Hackshaw | Emergency Medicine | 5176 Hill Rd E, Emergency Department, Lakeport, CA 95453-6300 | 2006-06-14 |
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| 1265051304 | Madhok Medical Corporation | Emergency Medicine | 2309 Noriega St # 5, San Francisco, CA 94122-4239 | 2020-04-09 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1376177402 | Aria Urgent Care Associates, Inc | Emergency Medicine | 601 S Beach Blvd, Anaheim, CA 92804-3102 | 2020-02-27 |
| 1851922900 | Anna Lankester Webster | Emergency Medicine | 1600 Los Gamos Dr Ste 220, San Rafael, CA 94903-1842 | 2020-01-28 |
| 1487294385 | Cep America - Auc PC | Emergency Medicine | 240 La Casa Via Ste 200, Walnut Creek, CA 94598-4866 | 2020-01-09 |
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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.