LUCILLE B. ANDERSEN (NPI# 1124082359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124082359 |
| Entity Type | Individual |
| Full Name | LUCILLE B. ANDERSEN |
| Credential | M.D. |
| Practice Address |
5924 Stoneridge Dr Suite 103 Pleasanton CA 94588-2887 |
| Practice Telephone | 9252632499 |
| Mailing Telephone | 9252632499 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2013-05-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | C54414 | CA | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | MD0426365 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1013707600001 | 05 |
| Street Address |
5924 STONERIDGE DR SUITE 103 |
| City | PLEASANTON |
| State | CA |
| Zip Code | 94588-2887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366813610 | Eun-ju Park | Acupuncturist | 5924 Stoneridge Dr, Suite 204a, Pleasanton, CA 94588-2887 | 2015-10-13 |
| 1407287592 | Accura Imaging, Inc | Radiologic Technologist | 5924 Stoneridge Dr, Suite 205, Pleasanton, CA 94588-2887 | 2013-11-27 |
| 1619318391 | Summit Surgery Center LLC | Clinic/Center | 5924 Stoneridge Dr, 206, Pleasanton, CA 94588-2887 | 2013-07-10 |
| 1235575051 | Andersen Orthopedics, A Professional Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr, Suite 103, Pleasanton, CA 94588-2887 | 2013-05-20 |
| 1194094144 | Marta Baird | Dentist | 5924 Stoneridge Dr, Suite 203, Pleasanton, CA 94588-2887 | 2011-12-20 |
| 1164708582 | Navin Mallavaram, M.d., Inc. | Pain Medicine | 5924 Stoneridge Dr, Suite 206, Pleasanton, CA 94588-2887 | 2011-10-31 |
| 1679855076 | East Bay Retina Consultants A Medical Group, Inc. | Ophthalmology | 5924 Stoneridge Dr, Suite 201, Pleasanton, CA 94588-2887 | 2011-09-13 |
| 1801192646 | Breastlink Medical Group Inc | Chiropractor | 5924 Stoneridge Dr, Suite 108, Pleasanton, CA 94588-2887 | 2011-01-26 |
| 1255633707 | Pain Medicine Consultants, Inc. | Durable Medical Equipment & Medical Supplies | 5924 Stoneridge Dr, Suite 102, Pleasanton, CA 94588-2887 | 2010-12-03 |
| 1609109412 | Sharmila Acharya | Physical Therapist | 5924 Stoneridge Dr, Suite 206, Pleasanton, CA 94588-2887 | 2009-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932786 | Kabafusion, LLC | Durable Medical Equipment & Medical Supplies | 5860 W. Las Positas Blvd, Suite 19, Pleasanton, CA 94588 | 2020-11-02 |
| 1619519691 | Vanessa Baldwin | Behavior Technician | 5828 Stoneridge Mall Road, Suit 205, Pleasanton, CA 94588 | 2019-10-11 |
| 1184187783 | Amanda Singh | Behavior Technician | 1811 Stoneridge Mall Rd Suite 205, Pleasanton, CA 94588 | 2019-04-10 |
| 1891262192 | Virginia Zamora | Behavior Technician | 5820 Stoneridgemall Rd, Suite 205, Pleasanton, CA 94588 | 2018-10-25 |
| 1891275368 | Ixchel N Baltazar | Behavioral Analyst | 520 Stoneridge Mall Rd, Ste. 205, Pleasanton, CA 94588 | 2018-08-15 |
| 1386149409 | Monique Imanii Brown | Behavioral Analyst | 511 Johnson Drive, Pleasanton, CA 94588 | 2018-03-29 |
| 1922509710 | Cierra Marie Barton | Behavioral Analyst | 5820 Stoneridge Mall Road, Suite 205, Pleasanton, CA 94588 | 2018-02-27 |
| 1851800056 | Delisa Simon | Nurse Practitioner | 4439 Stoneridge Dr Ste 110, Pleasanton, CA 94588 | 2017-09-20 |
| 1831611409 | One Health Hospice, Inc. | Hospice Care, Community Based | 7059 Commerce Cir, Suite G, Pleasanton, CA 94588 | 2017-07-14 |
| 1114478641 | Carlos Gavino | Behavior Technician | 5820 Stoneridge Mall Dr, Suite 205, Pleasanton, CA 94588 | 2016-10-19 |
| Find all providers in zip 94588 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275632663 | Donald W Rohren | Orthopaedic Surgery | 10 Bunker Ln, Pleasanton, CA 94566-9700 | 2006-09-21 |
| 1639282551 | Mission Peak Orthopaedic Medical Group, Inc | Orthopaedic Surgery | 5924 Stoneridge Drive, Suite 110, Pleasanton, CA 94588-5400 | 2006-08-16 |
| 1962479089 | Thomas J Blumenfeld | Orthopaedic Surgery | 5725 W Las Positas Blvd Ste 200, Pleasanton, CA 94588-4007 | 2006-03-07 |
| 1851368302 | Edward Elmer | Orthopaedic Surgery | 1102 N Main St, Pleasanton, TX 78064-2618 | 2006-03-03 |
| 1427053560 | Roger D. Dainer | Orthopaedic Surgery | 4626 Willow Road, Suite 200, Pleasanton, CA 94588-8564 | 2005-06-16 |
| 1982608733 | Julie A Long | Orthopaedic Surgery | 5725 W Las Positas Blvd, Suite 200, Pleasanton, CA 94588-4054 | 2005-06-09 |
| 1558754598 | Synergy Health Center & Urgent Care | Orthopaedic Surgery | 3128 Santa Rita Rd, Pleasanton, CA 94566-8300 | 2015-03-16 |
| 1235575051 | Andersen Orthopedics, A Professional Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr, Suite 103, Pleasanton, CA 94588-2887 | 2013-05-20 |
| 1366700270 | Margaret Eileen Cooke | Orthopaedic Surgery | 5725 W Las Positas Blvd Ste 200, Pleasanton, CA 94588-4007 | 2012-04-27 |
| 1679869515 | Anthony J. Porter Jr. | Orthopaedic Surgery | 4626 Willow Rd, Pleasanton, CA 94588 | 2011-06-20 |
| Find all providers in PLEASANTON | ||||
| City | PLEASANTON |
| Zip Code | 94588 |
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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.