SPORTS MEDICINE INSTITUTE INTERNATIONAL (NPI# 1003448614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003448614 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE INSTITUTE INTERNATIONAL |
| Practice Address |
260 Sheridan Ave Ste B40 Palo Alto CA 94306-2054 |
| Practice Telephone | 6503222809 |
| Practice Fax Number | 6503256980 |
| Mailing Telephone | 6503222809 |
| Mailing Fax Number | 6503256980 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | MRS. KENDRA FADIL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6503222809 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
260 SHERIDAN AVE STE B40 |
| City | PALO ALTO |
| State | CA |
| Zip Code | 94306-2054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126538 | Vasily Salov | Massage Therapist | 2313 Park Blvd, Palo Alto, CA 94306 | 2020-08-25 |
| 1568982569 | Shian Hong | Registered Nurse | 270 Grant Avenue, Palo Alto, CA 94306 | 2017-06-21 |
| 1386092229 | Woo Jung Park | Acupuncturist | 4290 Wilkie Way #c, Palo Alto, CA 94306 | 2016-06-01 |
| 1225442205 | Keiko Gill | Chiropractor | 480 California Ave Ste 103, Palo Alto, CA 94306 | 2014-06-17 |
| 1093147092 | Thuy Nguyen | Optometrist | 109 California Ave Ste D101a, Palo Alto, CA 94306 | 2013-08-01 |
| 1750685293 | Erica Mikhli | Physician Assistant | 300 Pasteur Drive Cvrb 2nd Floor, Stanford, CA 94306 | 2010-12-24 |
| 1225262553 | Rina Biren Shah | Family Medicine | 270 Grant Ave., Mayview Community Health Center, Palo Alto, CA 94306 | 2009-05-14 |
| 1669640173 | Leah Zialcita | Physical Therapist | 2345 Yale Street, Palo Alto, CA 94306 | 2008-02-19 |
| 1578761631 | Mary June Asenathe Wagner | Dentist | 1795 El Camino Real #100, Palo Alto, CA 94306 | 2007-07-10 |
| 1972628923 | Lillian Landsman Burt | Social Worker | 2 Roosevelt Circle, Palo Alto, CA 94306 | 2007-03-20 |
| Find all providers in zip 94306 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794108 | Hsunhao Wan | Massage Therapist | 4226 El Camino Real, Palo Alto, CA 94306-4404 | 2020-09-12 |
| 1073126538 | Vasily Salov | Massage Therapist | 2313 Park Blvd, Palo Alto, CA 94306 | 2020-08-25 |
| 1548735681 | Jason Wade Knisley | Massage Therapist | 855 El Camino Real Ste 13a-251, Palo Alto, CA 94301-2305 | 2018-10-04 |
| 1700280724 | Melanie Peddle | Massage Therapist | 665 Lytton Ave, Palo Alto, CA 94301-1335 | 2014-10-20 |
| 1194001875 | Charles C Koo | Massage Therapist | 430 Sherman Ave Ste 205, Palo Alto, CA 94306-1853 | 2011-10-26 |
| 1427185743 | Li Zhen Chen | Massage Therapist | 1101 Welch Rd, Suite A6, Palo Alto, CA 94304-1904 | 2007-02-27 |
| 1891821377 | Kathleen Nugent | Massage Therapist | 1101 Welch Rd, Suite A6, Palo Alto, CA 94304-1904 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164265 | Gary L Johnson | Massage Therapist | 222 Columbus Ave Ste 220, San Francisco, CA 94133-4597 | 2020-11-08 |
| 1720689508 | Cebrina Dieli | Massage Therapist | 470 Forest Park Blvd., C-212, Oxnard, CA 93036 | 2020-11-06 |
| 1528669348 | Matthew P Martinez | Massage Therapist | 417 N Citrus Ave Apt 7, Escondido, CA 92027-2765 | 2020-11-06 |
| 1841891603 | Jenni Asher | Massage Therapist | 5425 1/2 Vantage Avenue, Valley Village, CA 91607 | 2020-11-06 |
| 1316548456 | Paulo Conceicao | Massage Therapist | 6559 Comly St, San Diego, CA 92111-5401 | 2020-11-05 |
| 1023619079 | Reanna Whitnall | Massage Therapist | 9950 Campo Rd Ste 204, Spring Valley, CA 91977-1629 | 2020-11-05 |
| 1073114252 | Briana Hill | Massage Therapist | 2203 San Remo Cir, Vista, CA 92084-7727 | 2020-11-04 |
| 1770184954 | Michelle Ann Moeller | Massage Therapist | 5648 Oak Grove Ave, Oakland, CA 94618-1243 | 2020-11-04 |
| 1013518315 | Mayulee Wilawanwelsh | Massage Therapist | 349 S Lafayette Pk Pl, Los Angeles, CA 90057 | 2020-11-03 |
| 1194326553 | Suzanne Romero | Massage Therapist | 411 Alvarado St Apt 201, Monterey, CA 93940-2710 | 2020-11-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SPORTS MEDICINE INSTITUTE INTERNATIONAL.
| 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.