MILLS-PENINSULA MEDICAL GROUP (NPI# 1639384274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639384274 |
| Entity Type | Organization |
| Organization Name | MILLS-PENINSULA MEDICAL GROUP |
| Practice Address |
577 Airport Blvd Suite 300 Burlingame CA 94010-2020 |
| Practice Telephone | 6502408000 |
| Practice Fax Number | 6502400953 |
| Mailing Telephone | 6502408000 |
| Mailing Fax Number | 6502400953 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHARON KATZ (VP OF MEDICAL MANAGEMENT PRIVACY OF) |
| Authorized Official Telephone | 6502408053 |
| Authorized Official Credential | RN,ND |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
577 AIRPORT BLVD SUITE 300 |
| City | BURLINGAME |
| State | CA |
| Zip Code | 94010-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265478424 | Jesus Saucedo | Family Medicine | 577 Airport Blvd, Ste 300, Burlingame, CA 94010-2020 | 2006-06-22 |
| 1710536396 | Lenisha Bhukhan | Technician, Health Information | 577 Airport Blvd, Burlingame, CA 94010-2020 | 2019-09-06 |
| 1700968369 | Stewart Blandon | Internal Medicine | 577 Airport Blvd, Burlingame, CA 94010-2020 | 2006-10-20 |
| 1073601563 | Howard Michael Botwinick | Emergency Medicine | 577 Airport Blvd, Suite 300, Burlingame, CA 94010-2020 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071850 | Jilla Lavian | Social Worker | 1240 Lakeview Drive, San Mateo, CA 94010 | 2020-07-23 |
| 1982246575 | Golden State Heart & Vascular Associates | Internal Medicine | 1850 El Camino Real Ste 200, Burlingame, CA 94010 | 2019-10-15 |
| 1184182248 | Primrose Healing and Wellness, Inc. | Marriage & Family Therapist | 405 Primrose Rd, #320, Burlingame, CA 94010 | 2019-03-07 |
| 1720508724 | Monazza Chaudhry | Pharmacist | 1828 El Camino Real #104, Burlingame, CA 94010 | 2017-06-21 |
| 1861804007 | Heidi Platt | Counselor | 826 Mahler Road, Burlingame, CA 94010 | 2014-05-22 |
| 1144662685 | Scarlett M Reyes | Counselor | 1818 Gilbreth Road, Suite 230, Womens Recovery Association, Burlingame, CA 94010 | 2013-07-25 |
| 1760821979 | Elliot Naidus | Internal Medicine | 1720 El Camino Real Ste 150, Burlingame, CA 94010 | 2013-06-20 |
| 1831430651 | Huddleston Care, LLC | In Home Supportive Care | 1364 Drake Avenue, Burlingame, CA 94010 | 2013-03-04 |
| 1891070843 | Linda Susan Notario | Pharmacist | 260 El Camino Raal, Burlingame, CA 94010 | 2011-10-20 |
| 1063794006 | Tram Anh Le | Pharmacist | 260 N El Camino Real, Burlingame, CA 94010 | 2011-09-15 |
| Find all providers in zip 94010 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154503498 | Charles A Fracchia Jr. | General Practice | 784 Willborough Rd, Burlingame, CA 94010-3719 | 2007-11-28 |
| 1942495353 | Peter T. Banos | General Practice | 1217 Floribunda Ave, #4, Burlingame, CA 94010-8103 | 2007-09-09 |
| 1831303528 | Gessica Johnston | General Practice | 500 Airport Blvd Ste 100, Burlingame, CA 94010-1980 | 2007-05-10 |
| 1316055106 | Aitan Melamud | General Practice | 1828 El Camino Real, #605, Burlingame, CA 94010-3120 | 2006-08-29 |
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| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
| City | BURLINGAME |
| Zip Code | 94010 |
Please comment or provide details below to improve the information on MILLS-PENINSULA MEDICAL GROUP.
| 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.