PETER K MANSURIPUR (NPI# 1588984306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588984306 |
| Entity Type | Individual |
| Full Name | PETER K MANSURIPUR |
| Credential | M.D. |
| Practice Address |
975 Sereno Dr Vallejo CA 94589 |
| Mailing Address |
975 Sereno Dr Vallejo CA 94589-2441 |
| Practice Telephone | 7076512549 |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2018-12-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 14894 | RI | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | LP01956 | RI | Allopathic & Osteopathic Physicians |
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
A140883 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 1588984306 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 450 Broadway St, Pavilion C, Mc 6342, Redwood City, CA 940633132 | 6507217626 |
| Street Address |
975 SERENO DR |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940620 | James A Carolan | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2005-05-31 |
| 1386243483 | Chrismichael C Caniaveral | Pulmonary Function Technologist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-10-20 |
| 1598376188 | Justin Parungao Vallarta | Pharmacist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-08-16 |
| 1083232524 | Jeremy Cobb Mutter | Respiratory Therapist, Certified | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-07-10 |
| 1083230361 | Rabeea Abbas | Orthopaedic Surgery | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-06-22 |
| 1518588490 | Claudia S Vanover | Radiology | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-05-01 |
| 1013536937 | Nicole Anne Madrilejo | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-10 |
| 1457970527 | Sean N Ryan | Physical Therapist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-09 |
| 1528687787 | Natalie Sukie White | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-04-08 |
| 1801423223 | Jacqueline Yu | Student in an Organized Health Care Education/Training Program | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2020-03-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366903478 | Nabreea Dianna Moore | Behavioral Analyst | 1300 Donner Pass Rd, Vallejo, CA 94589 | 2019-03-29 |
| 1588131221 | Alejandra Hernandez De Leon | Behavioral Analyst | 151 Mimosa Ct, Vallejo, CA 94589 | 2018-10-31 |
| 1821588948 | Angela Ancheta Laco | Behavioral Analyst | 71 Los Cerritos Dr, Vallejo, CA 94589 | 2018-05-14 |
| 1851750764 | Shauntell Hudson | Counselor | 112 Basalt Dr, Vallejo, CA 94589 | 2016-02-19 |
| 1982997680 | Shuttle California Transit, LLC | Private Vehicle | 322 Lemon St, Vallejo, CA 94589 | 2011-05-27 |
| 1588813455 | Shay Teresa Loftus | Psychologist | 1761 Broadway, Suite 100, Vallejo, CA 94589 | 2008-09-16 |
| 1063629236 | Michael Francis Edziak | Dentist | 150 Hospital Dr., Vallejo, CA 94589 | 2007-05-17 |
| 1346454220 | Diljit Bahuleyan Karayil | Internal Medicine | 975 Sereno Drive, Medical Office- 8, Kaiser Permanente Medical Center, Vallejo, CA 94589 | 2007-05-09 |
| 1174745525 | Thomas Welch Gross | Emergency Medicine | Emergency Dept., Kaiser Permanente Medical Center, 675 Sereno Dr, Vallejo, CA 94589 | 2007-05-03 |
| 1639207756 | James D Prigmore | Dentist | 1620 Valle Vista Ave, Ste 100, Vallejo, CA 94589 | 2007-03-01 |
| Find all providers in zip 94589 | ||||
| Taxonomy Code | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477027050 | Bay Area Surgical Specialists | Orthopaedic Surgery | 2505 Samaritan Dr Ste 208, San Jose, CA 95124-4008 | 2019-01-16 |
| 1316484504 | James Angus Turner | Orthopaedic Surgery | 2190 Washington St, Suite 404, San Francisco, CA 94109-2869 | 2017-01-25 |
| 1477906717 | Phuc Dang, Md Corporation | Orthopaedic Surgery | 1006 Mission Dr Apt A, Suite 200, Costa Mesa, CA 92626-4217 | 2016-07-21 |
| 1528423506 | H. Relton Mccarroll Jr. Md A Medical Corporation | Orthopaedic Surgery | 2351 Clay St Ste 510, San Francisco, CA 94115-1931 | 2015-12-17 |
| 1598174492 | Paul J. Casey, Md Inc | Orthopaedic Surgery | 969 Blue Heron, Seal Beach, CA 90740-5611 | 2014-08-05 |
| 1023428901 | Austin Arlo Pitcher | Orthopaedic Surgery | 3315 Broadway Fl 1, Oakland, CA 94611-5717 | 2014-05-01 |
| 1932547536 | Hassan Jon Azimi | Orthopaedic Surgery | 8008 Frost St Ste 403, San Diego, CA 92123-4209 | 2013-06-06 |
| 1114265949 | Wayne Pan | Orthopaedic Surgery | 1475 Grandview Dr, Ms 354-g, Room 354171, South San Francisco, CA 94080-4901 | 2013-01-29 |
| 1720348162 | Ryu Yoshida | Orthopaedic Surgery | 8635 W 3rd St Ste 990w, Los Angeles, CA 90048-6116 | 2012-05-19 |
| 1285933424 | Anna Marie Acosta | Orthopaedic Surgery | 1760 Termino Ave Ste 308, Long Beach, CA 90804 | 2011-03-25 |
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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.