TEODORO P. NISSEN M.D., INC (NPI# 1629248109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629248109 |
| Entity Type | Organization |
| Organization Name | TEODORO P. NISSEN M.D., INC |
| Other Organization Name | BAY AREA ORTHOPEDIC SURGERY AND SPORTS MEDICINE |
| Practice Address |
100 Hospital Dr Suite 303 Vallejo CA 94589-2580 |
| Practice Telephone | 7076457210 |
| Practice Fax Number | 7076457249 |
| Mailing Telephone | 7076457210 |
| Mailing Fax Number | 7076457249 |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | DR. TEODORO PEDRO NISSEN (CEO) |
| Authorized Official Telephone | 7076457210 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A77901 | CA | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Bay Area Orthopedic Surgery and Sports Medicine | Other Name - Individual/Organization |
| Street Address |
100 HOSPITAL DR SUITE 303 |
| City | VALLEJO |
| State | CA |
| Zip Code | 94589-2580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649893660 | Stacyann Andaya | Nurse Practitioner | 100 Hospital Dr, Vallejo, CA 94589-2580 | 2020-05-26 |
| 1255792099 | Denise Veloria | Obstetrics & Gynecology | 100 Hospital Dr, Vallejo, CA 94589-2580 | 2016-03-07 |
| 1639546914 | Monica A. Muzzin | Physician Assistant | 100 Hospital Dr, Vallejo, CA 94589-2580 | 2015-08-21 |
| 1134466956 | Mount Diablo Solano Oncology Group | Internal Medicine | 100 Hospital Dr, Suite 110b, Vallejo, CA 94589-2580 | 2013-01-14 |
| 1528399193 | Solano Hematology - Oncology | Internal Medicine | 100 Hospital Dr, Suite 110, Vallejo, CA 94589-2577 | 2010-01-21 |
| 1760610273 | Stella Mai Huang | Obstetrics & Gynecology | 100 Hospital Dr, Suite 200, Vallejo, CA 94589-2580 | 2009-06-24 |
| 1982839692 | Sutter Valley Medical Foundation | Durable Medical Equipment & Medical Supplies | 100 Hospital Dr, Vallejo, CA 94589 | 2009-05-26 |
| 1760620983 | Lois Corina Baeta | Registered Nurse | 100 Hospital Dr, Vallejo, CA 94589-2580 | 2009-01-26 |
| 1598931446 | Nor Cal Medical Group | Podiatrist | 100 Hospital Dr, Suite 303, Vallejo, CA 94589-2580 | 2008-05-01 |
| 1316014913 | Sutter Solano Tcu | General Acute Care Hospital | 100 Hospital Dr, Vallejo, CA 94589-2578 | 2006-11-29 |
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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 | 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 |
|---|---|---|---|---|
| 1285061531 | Ronald David | Specialist | 9331 Big Ben Ct, Vallejo, CA 94591-8599 | 2013-10-02 |
| 1356397186 | Fred Rhode Stoddard | Specialist | 532 Oregon St, Vallejo, CA 94590-3254 | 2006-05-25 |
| 1487655841 | Mary Susan Shrimpton | Specialist | 5260 Zinfandel Ln, Vallejo, CA 94591-8391 | 2005-08-09 |
| 1316940620 | James A Carolan | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2005-05-31 |
| 1720532633 | Judith Miller-yamada | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2016-08-09 |
| 1427414259 | Marcela Macias | Specialist | 236 Georgia St, Vallejo, CA 94590-5991 | 2016-01-08 |
| 1821372871 | Amy Horan | Specialist | 100 Hospital Dr Ste 303, Vallejo, CA 94589-2583 | 2011-10-07 |
| 1982804027 | Natalie Rose Haffner | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2007-07-18 |
| 1144360793 | Harrold J. Dwyer | Specialist | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2007-02-06 |
| 1871655472 | Robert Brillantes | Specialist | 1027 Alabama St, Vallejo, CA 94590-4511 | 2006-12-14 |
| Find all providers in VALLEJO | ||||
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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.