PERMANENTE MEDICAL GROUP INC (NPI# 1639252604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639252604 |
| Entity Type | Organization |
| Organization Name | PERMANENTE MEDICAL GROUP INC |
| Practice Address |
1190 Veterans Blvd Redwood City CA 94063-2037 |
| Mailing Address |
1950 Franklin St Tpmg Financial Management 18th Flr Oakland CA 94612-5103 |
| Practice Telephone | 6502992000 |
| Mailing Telephone | 5109871000 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | MS. PATRICIA T WEST (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5102957207 |
| Is Organization Subpart | Y |
| Parent Organization Name | PERMANENTE MEDICAL GROUP, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GRN00011D | 05 | |
| MEDICARE RAILROAD | ZZZ20729Z | 01 | |
| CA | LAB62466F | 05 | |
| MEDICARE RAILROAD | ZZZ20730Z | 01 | |
| BLUE SHIELD | ZZZ20729Z | 01 | |
| CA | ZZZ20729Z | 05 | |
| CA | GRE001082 | 05 | |
| BLUE SHIELD | ZZZ20730Z | 01 | |
| MEDICARE RAILROAD | ZZZ27679Z | 01 | |
| CA | ZZZ20730Z | 05 | |
| CA | GR0046773 | 05 | |
| CA | GRE00108F | 05 | |
| CA | GRN000115 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841373800 | Permanente Medical Group Inc | Anesthesiology | 2238 Geary, San Francisco, CA 94116-3416 | 2006-10-23 |
| 1235226531 | Permanente Medical Group Inc | Surgery | 901 Nevin, Richmond, CA 94801-3143 | 2006-10-06 |
| 1336222397 | Permanente Medical Group Inc | Anesthesiology | 975 Sereno Drive, Vallejo, CA 94589-2441 | 2006-10-23 |
| 1548343510 | Permanente Medical Group Inc | Surgery | 7373 West Lane, Stockton, CA 95210-3377 | 2006-10-23 |
| 1073606299 | Permanente Medical Group Inc | Ophthalmology | 710 Lawrence Expressway, Santa Clara, CA 95051-5173 | 2006-10-02 |
| Street Address |
1190 VETERANS BLVD |
| City | REDWOOD CITY |
| State | CA |
| Zip Code | 94063-2037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093895245 | Roberta Heck | Nurse Practitioner | 1190 Veterans Blvd, Redwood City, CA 94063-2037 | 2006-10-16 |
| 1306209275 | Kirth Cucueco | Internal Medicine | 1190 Veterans Blvd, Redwood City, CA 94063-2037 | 2016-03-30 |
| 1396150298 | Kaiser Foundation Health Plan Inc | Pharmacy | 1190 Veterans Blvd, Cypress Bldg, Fl 2 Rm 110, Redwood City, CA 94063-2037 | 2014-06-30 |
| 1265790406 | Christopher Rodriguez | Internal Medicine | 1190 Veterans Blvd, Cypress Bldg., Redwood City, CA 94063-2037 | 2012-04-25 |
| 1811253214 | Linda Phuong Hoang | Internal Medicine | 1190 Veterans Blvd, Cypress Bulding 2nd Floor, Redwood City, CA 94063 | 2012-04-10 |
| 1225299688 | Dominique B Yang-kim | Internal Medicine | 1190 Veterans Blvd, Redwood City, CA 94063-2037 | 2008-06-18 |
| 1093852543 | Frances Weissbart | Nurse Practitioner | 1190 Veterans Blvd, Cardiology Department, Redwood City, CA 94063-2037 | 2007-01-31 |
| 1760562920 | Trudy A Keltz | Nurse Practitioner | 1190 Veterans Blvd, Sta C, Redwood City, CA 94063-2037 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578104378 | Jade Francetich | Psychologist | 450 Broadway St., Pavilion B 2nd Floor, Redwood City, CA 94063 | 2019-10-02 |
| 1861052060 | County of San Mateo | Clinic/Center | 1300 Maple St., Redwood City, CA 94063 | 2019-06-19 |
| 1750941977 | County of San Mateo | Clinic/Center | 300 Bradford St., Redwood City, CA 94063 | 2019-06-19 |
| 1023678661 | Linda K Watanabe | Preventive Medicine | 700 Bay Rd. #2803, Redwood City, CA 94063 | 2019-06-17 |
| 1235630369 | Waverly Place Apartments, Lp | Case Management | 105 Waverly Place, Redwood City, CA 94063 | 2018-02-23 |
| 1306371679 | Caely Alise Hambro | Student in an Organized Health Care Education/Training Program | Stanford Dermatology, 430 Broadway, Redwood City, CA 94063 | 2017-04-25 |
| 1609316736 | Justine Nicole Dela Cruz | Nurse Practitioner | 420 Broadway St # D, Redwood City, CA 94063 | 2017-03-08 |
| 1336683234 | Babita Chopra | Pharmacist | 2300 Middlefield Road, Redwood City, CA 94063 | 2016-12-12 |
| 1073065595 | Diana Genoveva Posner I | Counselor | 604 Prince Ave. Ste A, Redwood City, CA 94063 | 2016-11-01 |
| 1295288264 | Benjamin Dickter | Student in an Organized Health Care Education/Training Program | 1107 2nd Ave, Apt 103, Redwood City, CA 94063 | 2016-07-26 |
| Find all providers in zip 94063 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174151278 | Worthy Scripts LLC | Internal Medicine | 1120 Palm Ave, Redwood City, CA 94061-2728 | 2020-04-01 |
| 1316578750 | One Medical Group, Inc. | Internal Medicine | 1600 Seaport Blvd, Redwood City, CA 94063-5563 | 2020-02-03 |
| 1447804224 | Carexus Healthcare Services, Inc | Internal Medicine | 1513 Mitchell Way, Redwood City, CA 94061-2449 | 2019-07-30 |
| 1285066878 | Carlos Antonio Rivas | Internal Medicine | 300 Tadley Ct, Redwood City, CA 94061-4305 | 2013-08-06 |
| 1477833408 | Herbert Rudolf Neuman | Internal Medicine | 858 Corriente Point Dr, Redwood City, CA 94065-1285 | 2011-08-22 |
| 1689995870 | Logan Douglas Schneider | Internal Medicine | 450 Broadway St # Mc5704, Pavilion C, 2nd Floor, Redwood City, CA 94063-3132 | 2010-06-22 |
| 1174843916 | Priyasheelta Nand | Internal Medicine | 2950 Whipple Avenue, Suite 3, Redwood City, CA 94062 | 2010-06-03 |
| 1770800245 | Gerald Cera | Internal Medicine | 1011 Whitehall Ln., Redwood City, CA 94061 | 2010-04-23 |
| 1346572849 | Neda N. Pakdaman, Md Professional Corporation | Internal Medicine | 274 Redwood Shores Pkwy, Ste 236, Redwood City, CA 94065-1173 | 2010-02-08 |
| 1912167420 | Curtis Robert Chong | Internal Medicine | 440 Broadway St Fl B35m3, Redwood City, CA 94063-3123 | 2008-06-10 |
| Find all providers in REDWOOD CITY | ||||
| City | REDWOOD CITY |
| Zip Code | 94063 |
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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.