PEDIAHEALTH MEDICAL GROUP, INC. (NPI# 1003913971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003913971 |
| Entity Type | Organization |
| Organization Name | PEDIAHEALTH MEDICAL GROUP, INC. |
| Practice Address |
901 Campus Dr Suite 210 Daly City CA 94015-4900 |
| Practice Telephone | 6509943000 |
| Mailing Telephone | 6509943000 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. OFELIA MARISTELA (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 6509943000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | A32383 | CA | Ambulatory Health Care Facilities |
| Street Address |
901 CAMPUS DR SUITE 210 |
| City | DALY CITY |
| State | CA |
| Zip Code | 94015-4900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804230 | David D Tran | Podiatrist | 901 Campus Dr, #311, Daly City, CA 94015-4900 | 2005-07-11 |
| 1023516929 | Helene Michelle Omansky | Social Worker | 901 Campus Dr, Daly City, CA 94015 | 2018-01-25 |
| 1831556471 | Home Health Bay Area Inc. | Home Health | 901 Campus Dr, #301, Daly City, CA 94015-4900 | 2016-01-27 |
| 1922307842 | Jessica Sarah Wilcox | Physician Assistant | 901 Campus Dr, Suite 111, Daly City, CA 94015-4900 | 2011-03-17 |
| 1346556438 | Stephanie Speizer | Physician Assistant | 901 Campus Dr, Suite 111, Daly City, CA 94015-4900 | 2010-08-26 |
| 1720309354 | Danicka Xuan Le | Nurse Practitioner | 901 Campus Dr, Suite 112, Daly City, CA 94015-4900 | 2010-06-17 |
| 1588989321 | Roxanna R Shafiee | Dentist | 901 Campus Dr, Suite 212, Daly City, CA 94015-4900 | 2010-04-05 |
| 1639404692 | Aldrich Sy | Dentist | 901 Campus Dr, Ste 204, Daly City, CA 94015-4900 | 2009-10-08 |
| 1265665038 | Qualium Corp. | Clinic/Center | 901 Campus Dr, Suite 306, Daly City, CA 94015-4900 | 2009-08-27 |
| 1134357858 | Raemund P. Galang | Dentist | 901 Campus Dr, Suite 201 Physicians Medical Building, Daly City, CA 94015-4900 | 2009-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881235901 | Fast Express Ride Inc | Non-emergency Medical Transport (VAN) | 381 Westlake Ctr # 292, Daly City, CA 94015 | 2019-09-30 |
| 1598231888 | National Vision Inc | Technician/Technologist | 148a Serramonte Center, Daly City, CA 94015 | 2018-10-15 |
| 1174017313 | Glaiza Cecilia S Canares | Student in an Organized Health Care Education/Training Program | 255 Dennis Drive, Daly City, CA 94015 | 2018-06-20 |
| 1154869477 | Noah Bautista | Massage Therapist | 151 87th St Suite 4, Daly City, CA 94015 | 2017-02-07 |
| 1417387291 | Accuquest Hearing Centers | Clinic/Center | 10 Park Plaza Dr., Daly City, CA 94015 | 2013-11-15 |
| 1801193800 | Carol Crane | Physical Therapy Assistant | 333 Gellert Dr., Suite 150, Supplemental Health Care, Daly City, CA 94015 | 2011-02-28 |
| 1366753808 | Emerito Cesar C Nunag | Physical Therapy Assistant | 595 Clarinada Avenue #2, Daly City, CA 94015 | 2010-06-30 |
| 1356668016 | Lauren Rose Hendrick | Marriage & Family Therapist | 355 Gellert Blvd Suite 280, Daly City, CA 94015 | 2010-04-21 |
| 1205061868 | Isabel A. Walsh | General Practice | 783 Skyline Dr., Daly City, CA 94015 | 2009-05-26 |
| 1790933539 | Frank Geoffrey Yeh | Dentist | 1440 Southgate Ave., Daly City, CA 94015 | 2008-09-05 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245276716 | County of San Mateo | Clinic/Center | 2780 Junipero Serra Blvd, Daly City, CA 94015-1634 | 2006-06-21 |
| 1467004770 | Kpc Global Medical Center of San Mateo County LLC | Clinic/Center | 1900 Sullivan Ave, Daly City, CA 94015-2200 | 2019-07-16 |
| 1548641939 | Tony Lee Wong, Md., Inc. | Clinic/Center | 1800 Sullivan Ave Rm 104, Daly City, CA 94015-2227 | 2015-06-11 |
| 1336565480 | Christian Bocobo M.d. Professional | Clinic/Center | 1850 Sullivan Ave, Suite 310, Daly City, CA 94015-2221 | 2014-03-13 |
| 1588957401 | Sound Pediatrics | Clinic/Center | 333 Gellert Blvd, Suite 229, Daly City, CA 94015-2621 | 2011-05-25 |
| 1720130412 | St. Elizabeth Ann Seton New Life Center | Clinic/Center | 1500 Southgate Ave, Suite 112, Daly City, CA 94015-2259 | 2007-01-16 |
| 1528120151 | San Mateo Medical Center | Clinic/Center | 380 90th St, Daly City, CA 94015-1807 | 2006-12-13 |
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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.