BANCROFT PEDIATRIC MEDICAL GROUP (NPI# 1316903461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316903461 |
| Entity Type | Organization |
| Organization Name | BANCROFT PEDIATRIC MEDICAL GROUP |
| Other Organization Name | BANCROFT PEDIATRIC MEDICAL GROUP |
| Practice Address |
1555 Doolittle Dr. 180 San Leandro CA 94577 |
| Mailing Address |
1555 Doolittle Dr Ste 180 San Leandro CA 94577-2239 |
| Practice Telephone | 5104832600 |
| Practice Fax Number | 5104832605 |
| Mailing Telephone | 5104832600 |
| Mailing Fax Number | 5104832605 |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-01-06 |
| Authorized Official Name | MIRIAN RHEW (SENIOR PARTNER) |
| Authorized Official Telephone | 5104832600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LAURA DENENBERG MD LICENS | A60244 | 01 | |
| MIRIAM M RHEW MD LICENSE | A63066 | 01 | |
| STEVE SANTUCCI MD LICENSE | A63180 | 01 | |
| CA | MICHELE TAMSE | 20A10768 | 01 |
| LAURA GRUNBAUM MD LICENSE | G80985 | 01 | |
| CA | DARCY GRANT LICENSE | A102586 | 01 |
| MARIA E BEAMER MD LICENSE | A40292 | 01 | |
| CA | JUDITH MILLSTEIN LICENSE | A128385 | 01 |
| CA | REI MASUI LICENSE | A69220 | 01 |
| Other Name | Type Code |
|---|---|
| Bancroft Pediatric Medical Group | Doing Business As Name - Organization |
| Street Address |
1555 DOOLITTLE DR. 180 |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093358574 | A Caring Heart Home Health Inc. | In Home Supportive Care | 215-237 Estudillo Ave, Suite 202, San Leandro, CA 94577 | 2019-10-28 |
| 1871070052 | New Connections Neuropsychology, PC | Clinical Neuropsychologist | 1057 Macarthur Blvd, Ste 214, San Leandro, CA 94577 | 2018-07-20 |
| 1790287266 | Jennifer Capilla | Behavior Technician | 333 Estudillo Ave #204, San Leandro, CA 94577 | 2018-03-01 |
| 1891296760 | Maryann Kruse Bens | Clinical Neuropsychologist | 1057 Macarthur Blvd Ste 214, San Leandro, CA 94577 | 2018-02-26 |
| 1811406721 | Brendon Hoang Nguyen | Dentist | 145 E 14th St, San Leandro, CA 94577 | 2017-09-22 |
| 1801311774 | Calvin Walker | Counselor | 3801 Teagarden Street, San Leandro, CA 94577 | 2017-08-11 |
| 1184154999 | Shauntrinae Mason | Marriage & Family Therapist | 1000 San Leandro Blvd., Suite 300, San Leandro, CA 94577 | 2017-06-14 |
| 1912453135 | Dr. Marshea Evans | Point of Service | 1068 E14th Street, San Leandro, CA 94577 | 2016-08-28 |
| 1902252935 | Mobility Express Medical Transportation | Non-emergency Medical Transport (VAN) | 1695 Abram Ct Ste 202, San Leandro, CA 94577 | 2016-05-09 |
| 1194170381 | Girls Incorporated of Alameda County | Community/Behavioral Health | 2251 Bancroft Ave, San Leandro, CA 94577 | 2016-04-26 |
| Find all providers in zip 94577 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417498825 | Baychildren's Physicians | Pediatrics | 1555 Doolittle Dr, #180, San Leandro, CA 94577-2239 | 2017-03-17 |
| 1174794796 | Katherine M Gallagher | Pediatrics | 1555 Doolittle Drive, Bancroft Pediatrics, San Leandro, CA 94577 | 2008-03-23 |
| 1336265883 | Michele Marie Tamse | Pediatrics | 1555 Doolittle Dr Ste 180, San Leandro, CA 94577-2239 | 2007-03-22 |
| 1932280583 | Lawrence M Ng | Pediatrics | 101 Callan Ave, Suite 105, San Leandro, CA 94577-4854 | 2006-10-18 |
| 1558442020 | Li Zhu | Pediatrics | 101 Callan Ave Ste 105, San Leandro, CA 94577-4584 | 2006-10-18 |
| 1407954902 | Christina Chang-lyn Chow | Pediatrics | 3081 Teagarden St, San Leandro, CA 94577-5720 | 2006-09-20 |
| 1952325292 | Tomas Antonio Magana | Pediatrics | 16335 E. 14th St., San Leandro, CA 94578 | 2006-07-27 |
| 1952350936 | Maria Elena Beamer | Pediatrics | 1300 Bancroft Ave, San Leandro, CA 94577-5147 | 2006-05-08 |
| 1114989951 | Arnold J Blustein | Pediatrics | 1235 Harrison St, San Leandro, CA 94577-4515 | 2006-04-05 |
| 1700299260 | Uma Vinayagasundaram | Pediatrics | 2500 Merced Street, Kaiser Foundation Hospital- San Leandro, San Leandro, CA 94577 | 2014-06-03 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94577 |
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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.