THE PILL CLUB MEDICAL GROUP, INC (NPI# 1558801837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558801837 |
| Entity Type | Organization |
| Organization Name | THE PILL CLUB MEDICAL GROUP, INC |
| Other Organization Name | DAVID SVEC MD INC. |
| Practice Address |
411 Borel Avenue # 100 San Mateo CA 94402-3522 |
| Practice Telephone | 6502856927 |
| Practice Fax Number | 8883527383 |
| Mailing Telephone | 6502856927 |
| Mailing Fax Number | 8883527383 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2020-08-24 |
| NPI Deactivation Date | 10/09/2019 |
| NPI Reactivation Date | 2019-10-18 |
| Authorized Official Name | SAJAD ZALZALA (OWNER) |
| Authorized Official Telephone | 6502856927 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| David Svec MD Inc. | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | THE PILL CLUB MEDICAL GROUP, INC. | 411 Borel Ave, Suite 100, San Mateo, CA 94402 |
| New York State Corporations | THE PILL CLUB MEDICAL GROUP, INC. | 80 State Street, Albany, New York 12207-2543 |
| Connecticut Business Registrations | The Pill Club Medical Group, Inc. | 133 Arch St., Ste. 7, Redwood City, CA 94062 |
| Oregon Corporations, Companies and Business Names | THE PILL CLUB MEDICAL GROUP, INC. | 133 Arch Street Ste 7, Redwood City, CA 94062 |
| Washington State Corporations | THE PILL CLUB MEDICAL GROUP, INC. | 133 Arch St Ste 7, Redwood City, CA 94062-1326 |
| Street Address |
411 BOREL AVENUE # 100 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94402-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881175248 | The Pill Club Medical Group Professional Corporation | Specialist | 411 Borel Avenue, # 100, San Mateo, CA 94402-3522 | 2018-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154227 | Mark Cameron Head | Non-emergency Medical Transport (VAN) | 331 Sonora Drive, San Mateo, CA 94402 | 2020-11-06 |
| 1669032868 | County of San Mateo | Clinic/Center | 222 Paul Scannell Dr., San Mateo, CA 94402 | 2019-06-19 |
| 1417443755 | Suen Leung | Counselor | 800 Edinburgh St, San Mateo, CA 94402 | 2018-07-10 |
| 1760997902 | Blue Lotus Connection | Point of Service | 1700 S Amphlett Blvd, Ste 250b, San Mateo, CA 94402 | 2017-12-11 |
| 1982122503 | Madeline Pielert | Social Worker | 1670 S. Amphlett Blvd. 115, San Mateo, CA 94402 | 2017-09-04 |
| 1629512348 | Travis Woodmansee | Marriage & Family Therapist | 419 S El Dorado St, San Mateo, CA 94402 | 2016-12-14 |
| 1669820858 | Mohan Sundareson | Pediatrics | 1638 South Grant St, San Mateo, CA 94402 | 2016-05-27 |
| 1457712572 | New Life Acupuncture Clinic | Acupuncturist | 1720 South Amphlett Blvd # 168, San Mateo, CA 94402 | 2016-03-17 |
| 1871951434 | Nanami Oba | Physical Therapy Assistant | 20 Bennigton Dr., San Mateo, CA 94402 | 2016-02-10 |
| 1780059733 | Adrianna Cimera | Behavioral Analyst | 1710 South Amphlett Blvd, Suite 314, San Mateo, CA 94402 | 2015-12-02 |
| Find all providers in zip 94402 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194893875 | Immediate Medical Care Inc | Family Medicine | 2905 S El Camino Real, San Mateo, CA 94403 | 2006-12-01 |
| 1184617136 | Alexander Moldanado | Family Medicine | 50 S San Mateo Dr, Suite 230, San Mateo, CA 94401-3857 | 2005-08-25 |
| 1851396469 | Tommy Tzu-fong Kuo | Family Medicine | 1 Baywood Ave, Ste 8, San Mateo, CA 94402-1537 | 2005-06-20 |
| 1609417567 | Lilly Chavez | Family Medicine | 117 N San Mateo Dr, San Mateo, CA 94401-2793 | 2019-10-02 |
| 1013483320 | Osteopathic Touch, Inc. | Family Medicine | 2555 Flores St Ste 395, San Mateo, CA 94403-2344 | 2018-10-15 |
| 1710164371 | Enrique Sanchez Mendez | Family Medicine | 100 S San Mateo Dr, San Mateo, CA 94401-3805 | 2008-01-25 |
| 1346370137 | Milan Radojicic | Family Medicine | 100 S San Mateo Dr, San Mateo, CA 94401-3805 | 2007-03-07 |
| 1013043934 | Gary Huey | Family Medicine | 1 Baywood Ave, Suite 9, San Mateo, CA 94402-1537 | 2007-02-26 |
| 1407999089 | Daniel Teng | Family Medicine | 1000 Franklin Pkwy, San Mateo, CA 94403-1922 | 2007-02-14 |
| 1417099763 | Agnes Betty Lou Cosgrove | Family Medicine | 1 Baywood Ave, San Mateo, CA 94402-1523 | 2007-02-13 |
| Find all providers in SAN MATEO | ||||
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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.