DR. MERVYN K OTSUKA (NPI# 1053427138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053427138 |
| Entity Type | Individual |
| Full Name | DR. MERVYN K OTSUKA |
| Credential | DDS |
| Practice Address |
931 San Bruno Ave W Suite 5 San Bruno CA 94066-3440 |
| Practice Telephone | 6505886740 |
| Mailing Telephone | 6505886740 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
17531 | CA | Dental Providers |
| Street Address |
931 SAN BRUNO AVE W SUITE 5 |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-3440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518310523 | Edgewood Center for Children and Families | Community/Behavioral Health | 931 San Bruno Ave W, San Bruno, CA 94066 | 2016-07-14 |
| 1457745333 | Darryl Mendioro | Counselor | 931 San Bruno Ave W, San Bruno, CA 94066-3440 | 2015-03-27 |
| 1033517081 | Alilia L Vuna | Counselor | 931 San Bruno Ave W, Ste. #1, San Bruno, CA 94066-3440 | 2014-12-08 |
| 1124326541 | Ashley Lynn Theisen | Counselor | 931 San Bruno Ave W, San Bruno, CA 94066-3440 | 2011-03-09 |
| 1497957971 | Steven Richard Pulido | Dentist | 931 San Bruno Ave W, Suite 5, San Bruno, CA 94066-4327 | 2007-06-05 |
| 1023223195 | Les Chui | Chiropractor | 931 San Bruno Ave W, #1, San Bruno, CA 94066-3440 | 2007-05-11 |
| 1740328152 | Nancy Madera | Dentist | 931 San Bruno Ave W, Suite 6, San Bruno, CA 94066-3440 | 2007-02-01 |
| 1952417719 | Frank L Ng | Dentist | 931 San Bruno Ave W, Suite 8, San Bruno, CA 94066-3440 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558911313 | Kim Xuan Tran D.d.s., Inc. | Dentist | 1001 Sneath Ln Ste 211, San Bruno, CA 94066-2349 | 2019-09-13 |
| 1184090235 | Rowena Romero | Dentist | 528 Green Ave, San Bruno, CA 94066-4313 | 2015-08-12 |
| 1245527472 | Nicole L Pham | Dentist | 3303 Aegean Way, San Bruno, CA 94066-4570 | 2011-07-08 |
| 1487866851 | Maria Corazon Roque David-arrobio | Dentist | 105 El Camino Real, San Bruno, CA 94066-5426 | 2007-05-05 |
| 1104044064 | Ankur B Parikh | Dentist | 1490 El Camino Real, San Bruno, CA 94066-5301 | 2007-04-23 |
| 1023131513 | John Joseph Russo | Dentist | 1101 El Camino Real, San Bruno, CA 94066-2405 | 2007-04-09 |
| 1346381472 | Taisen Lin | Dentist | 504 Linden Ave, San Bruno, CA 94066-4243 | 2007-02-09 |
| 1316028178 | Maria Luisa F Diaz | Dentist | 851 Cherry Ave Ste 36, San Bruno, CA 94066-2954 | 2006-10-18 |
| 1588750046 | Gary R. Parsons | Dentist | 2102 Crestmoor Dr, San Bruno, CA 94066-2802 | 2006-10-04 |
| 1144335894 | Bradley L Parker | Dentist | 750 Kains Ave, San Bruno, CA 94066-3432 | 2006-08-21 |
| Find all providers in SAN BRUNO | ||||
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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.