PHOENIX EMERGENCY PHYSICIANS (NPI# 1689665317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689665317 |
| Entity Type | Organization |
| Organization Name | PHOENIX EMERGENCY PHYSICIANS |
| Practice Address |
13855 E 14th St San Leandro CA 94578-2611 |
| Mailing Address |
4301 Northstar Way Modesto CA 95356-9262 |
| Practice Telephone | 2093422300 |
| Practice Fax Number | 2095244240 |
| Mailing Telephone | 2093422300 |
| Mailing Fax Number | 2095244240 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2008-08-26 |
| Authorized Official Name | GAIL ANN HUBBELL (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2093422300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 27483 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0053820 | 05 | |
| CA | BLUE SHIELD | ZZZ34666Z | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Ohio Business Entities | PHOENIX EMERGENCY PHYSICIANS OF THE MIDWEST, LLC | 2828 Croasdaile Dr., Durham, NC 27705 |
| Street Address |
13855 E 14TH ST |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-2611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174053573 | Ada Wei Hsin Lien | Physician Assistant | 13855 E 14th St, San Leandro, CA 94578-2611 | 2017-06-18 |
| 1881124220 | Genevieve Marie Terry | Physician Assistant | 13855 E 14th St, San Leandro, CA 94578-2611 | 2017-06-18 |
| 1699200709 | David Tseng | Internal Medicine | 13855 E 14th St, San Leandro, CA 94578-2600 | 2017-04-26 |
| 1922460617 | Dennis Ha | Internal Medicine | 13855 E 14th St, San Leandro, CA 94578-2611 | 2016-03-22 |
| 1104267848 | Alameda Health System | General Acute Care Hospital | 13855 E 14th St, San Leandro, CA 94578-2611 | 2013-07-10 |
| 1215371745 | Lindsay Elizabeth Allen | General Acute Care Hospital | 13855 E 14th St, San Leandro, CA 94578-2611 | 2013-04-26 |
| 1154664241 | Sarah Archenbronn | Nurse Practitioner | 13855 E 14th St, San Leandro, CA 94578 | 2013-03-27 |
| 1548536006 | Eden Medical Center | General Acute Care Hospital | 13855 E 14th St, San Leandro, CA 94578-2611 | 2012-03-29 |
| 1720367295 | Cep America - California | Emergency Medicine | 13855 E 14th St, San Leandro, CA 94578-2611 | 2011-08-15 |
| 1295049740 | Rubinder Kaur | Internal Medicine | 13855 E 14th St, San Leandro, CA 94578-2611 | 2010-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578763413 | David Kyung-il Park | Emergency Medicine | 2500 Merced Sreet, San Leandro, CA 94577-4201 | 2007-07-19 |
| 1457457863 | Peter J Perez | Emergency Medicine | 15516 East 14th St, San Leandro, CA 94578 | 2006-09-15 |
| 1548204787 | California Emergency Physicians Medical Group | Emergency Medicine | 2800 Benedict Drive, San Leandro, CA 94577 | 2006-06-16 |
| 1558333443 | Kenneth R Harley | Emergency Medicine | 13851 E 14th St, Suite 102, San Leandro, CA 94578-2631 | 2006-02-03 |
| 1013370931 | Chin-hsiang Feng | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577-4201 | 2016-03-29 |
| 1306208855 | Adam Brown | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577-4201 | 2016-03-23 |
| 1619362035 | Louis Yu | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577-4201 | 2015-04-02 |
| 1376937938 | Lawrence Lau | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577 | 2015-03-22 |
| 1831501741 | Benjamin Anthony Feldman | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577 | 2014-05-27 |
| 1821438565 | Lucy Hormberg | Emergency Medicine | 2500 Merced St, San Leandro, CA 94577-4201 | 2013-06-26 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
Please comment or provide details below to improve the information on PHOENIX EMERGENCY PHYSICIANS.
| 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.