IMPAKT MEDICAL, LLC (NPI# 1376143479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376143479 |
| Entity Type | Organization |
| Organization Name | IMPAKT MEDICAL, LLC |
| Practice Address |
14125 Capri Dr Ste 8 Los Gatos CA 95032-1516 |
| Mailing Address |
9722 Fair Oaks Blvd Ste B Fair Oaks CA 95628-7039 |
| Practice Telephone | 4083317773 |
| Practice Fax Number | 8332278034 |
| Mailing Telephone | 4084805811 |
| Mailing Fax Number | 8332278034 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | BRYANT P MAJERNIK (VICE PRESIDENT) |
| Authorized Official Telephone | 9168447800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417429648 | Impakt Medical, LLC | Durable Medical Equipment & Medical Supplies | 700 Frederick St Ste 301, Santa Cruz, CA 95062-2239 | 2018-12-28 |
| 1992299838 | Impakt Medical, LLC | Durable Medical Equipment & Medical Supplies | 9722 Fair Oaks Blvd Ste B, Fair Oaks, CA 95628-7039 | 2018-06-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | IMPAKT MEDICAL, LLC | 9722 Fair Oaks Blvd Ste B, Fair Oaks, CA 95628-7039 |
| Street Address |
14125 CAPRI DR STE 8 |
| City | LOS GATOS |
| State | CA |
| Zip Code | 95032-1516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346730157 | Stephanie Chui | Optometrist | 15055 Los Gatos Blvd Ste 300, Los Gatos, CA 95032 | 2018-05-16 |
| 1710474960 | Lisa Richardson | Dietitian, Registered | 15405 Los Gatos Blvd #101, Los Gatos, CA 95032 | 2018-04-13 |
| 1235652934 | Nillofar Tabibi | Pharmacist | 1496 Pollard Road, Los Gatos, CA 95032 | 2017-07-25 |
| 1609397694 | Taylor Dolores Peterson | Marriage & Family Therapist | 15495 Los Gatos Blvd Ste 5, Los Gatos, CA 95032 | 2017-06-29 |
| 1942755418 | Michelle Sunalp | Physician Assistant | 14830 Los Gatos Blvd, Suite 300, Los Gatos, CA 95032 | 2016-08-24 |
| 1295196640 | Mandice Williams | Chiropractor | 236 Oak Meadow Dr, Los Gatos, CA 95032 | 2016-03-14 |
| 1922465020 | Los Gatos Dental Specialists | Dentist | 15075 Los Gatos Blvd, Ste 120, Los Gatos, CA 95032 | 2016-01-20 |
| 1962881813 | Los Gatos Snf, LLC | Skilled Nursing Facility | 16605 Lark Ave., Los Gatos, CA 95032 | 2015-05-26 |
| 1720404312 | Jonathan Davies | Physician Assistant | 15466 Los Gatos Blvd Ste 109-353, Los Gatos, CA 95032 | 2014-03-06 |
| 1588002612 | Jessica Velasco Gutierrez | Licensed Vocational Nurse | 634 W Parr Ave #116, Los Gatos, CA 95032 | 2013-06-11 |
| Find all providers in zip 95032 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932495918 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 470 N Santa Cruz Ave, Los Gatos, CA 95030-5313 | 2011-06-28 |
| 1083622146 | Matsuo Enterprises Inc | Durable Medical Equipment & Medical Supplies | 14107 Winchester Blvd Ste M, Los Gatos, CA 95032-1836 | 2006-08-04 |
| 1205842598 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 15920 Los Gatos Boulevard, Los Gatos, CA 95032-3424 | 2006-07-31 |
| 1730194069 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 423 N Santa Cruz Ave, Los Gatos, CA 95030-5320 | 2006-07-29 |
| 1992734909 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 15549 Union Ave, Los Gatos, CA 95032-3904 | 2006-07-02 |
| 1679864227 | Hearwell Audiology Inc. | Durable Medical Equipment & Medical Supplies | 14911 National Ave, #2, Los Gatos, CA 95032 | 2011-04-29 |
| 1285886804 | Sleepquest, Inc. | Durable Medical Equipment & Medical Supplies | 16400 Lark Ave, Suite 210, Los Gatos, CA 95032-2547 | 2008-10-14 |
| 1295913192 | Richard M Meltzer, Dpm | Durable Medical Equipment & Medical Supplies | 15100 Los Gatos Blvd, Ste 4, Los Gatos, CA 95032-2028 | 2008-02-04 |
| 1396884185 | John Miles Au.d. | Durable Medical Equipment & Medical Supplies | 14911 National Ave Ste 2, Los Gatos, CA 95032-2632 | 2007-02-06 |
| 1801940085 | Qualium Corp. | Durable Medical Equipment & Medical Supplies | 14981 National Ave, Suite 1, Los Gatos, CA 95032-2600 | 2007-01-23 |
| Find all providers in LOS GATOS | ||||
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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.