MILLS PENINSULA MEDICAL GROUP (NPI# 1588879134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588879134 |
| Entity Type | Organization |
| Organization Name | MILLS PENINSULA MEDICAL GROUP |
| Other Organization Name | MILLS-PENINSULA MEDICAL GROUP CLINICS |
| Practice Address |
50 S San Mateo Dr Suite 150 San Mateo CA 94401-3857 |
| Practice Telephone | 6506969770 |
| Practice Fax Number | 6503751363 |
| Mailing Telephone | 6506969770 |
| Mailing Fax Number | 6503751363 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-01-31 |
| Authorized Official Name | TRUDY BRADY (CLINIC DIRECTOR) |
| Authorized Official Telephone | 6502408011 |
| Authorized Official Credential | LVN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mills-Peninsula Medical Group Clinics | Other Name - Individual/Organization |
| Street Address |
50 S SAN MATEO DR SUITE 150 |
| City | SAN MATEO |
| State | CA |
| Zip Code | 94401-3857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184617136 | Alexander Moldanado | Family Medicine | 50 S San Mateo Dr, Suite 230, San Mateo, CA 94401-3857 | 2005-08-25 |
| 1649664301 | Peninsula Endoscopy Center LLC | Clinic/Center | 50 S San Mateo Dr, Suite 400, San Mateo, CA 94401-3861 | 2015-03-20 |
| 1518395169 | Hayley Skinner Brown | Nurse Practitioner | 50 S San Mateo Dr, Ste 230, San Mateo, CA 94401-3857 | 2013-10-17 |
| 1669748026 | Endocrinology, Metabolism and Clinical Nutrition Practice | Dietitian, Registered | 50 S San Mateo Dr, Suite 370, San Mateo, CA 94401-3857 | 2012-03-29 |
| 1881960797 | Endocrinology,metabolism,and Clinical Nutrition Practice | Dietitian, Registered | 50 S San Mateo Dr, Suite 370, San Mateo, CA 94401-3857 | 2012-03-25 |
| 1699067371 | California Anesthesia Network Nursing Services, PC | Anesthesiology | 50 S San Mateo Dr, Suite 400, San Mateo, CA 94401-3857 | 2011-05-12 |
| 1407148810 | California Anesthesia Network Services, PC | Anesthesiology | 50 S San Mateo Dr, Suite #400, San Mateo, CA 94401-3857 | 2011-05-04 |
| 1942523394 | Michael David Carson | Optometrist | 50 S San Mateo Dr, Suite 200, San Mateo, CA 94401-3857 | 2010-03-11 |
| 1720315161 | Bay Area Sports Clinic | Specialist | 50 S San Mateo Dr, Suite 470, San Mateo, CA 94401-3857 | 2009-11-05 |
| 1629209465 | Emily Yu, Md, Medical Corporation | Obstetrics & Gynecology | 50 S San Mateo Dr, Suite 420, San Mateo, CA 94401-3857 | 2009-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800760 | Monica Marie Rivas | Behavior Technician | 429 Peninsula Avenue, San Mateo, CA 94401 | 2020-08-05 |
| 1609412865 | Cindy Toshiko Hedlin | Marriage & Family Therapist | 1117 S. B Street, Suite 9, San Mateo, CA 94401 | 2019-11-22 |
| 1750846655 | James Court Manor Inc. | Assisted Living Facility | 1316 James Court, San Mateo, CA 94401 | 2019-02-05 |
| 1467991778 | Maria Elena Lopez | Student in an Organized Health Care Education/Training Program | 325 Villa Terrace, San Mateo, CA 94401 | 2017-02-20 |
| 1487198339 | Johnie Pangelina | Behavioral Analyst | 242 Peninsula Ave, San Mateo, CA 94401 | 2016-12-12 |
| 1740736230 | Meredith Eileen Morgan | Dentist | 100 S. Ellsworth Av, #601, San Mateo, CA 94401 | 2016-08-25 |
| 1376998963 | Lior Tamir | Dentist | 800 B Street Suite #200, San Mateo, CA 94401 | 2016-05-02 |
| 1609233584 | Delicia Ortega | Behavioral Analyst | 424 Peninsula Avenue, San Mateo, CA 94401 | 2016-01-22 |
| 1396122388 | Ramy Salah | Internal Medicine | 50 S San Mateo Dr Ste 480, San Mateo, CA 94401 | 2015-04-29 |
| 1508255902 | Risso Counseling, Inc. | Marriage & Family Therapist | 120 North El Camino Real, San Mateo, CA 94401 | 2015-01-22 |
| Find all providers in zip 94401 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275197899 | Connie Chen | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-29 |
| 1063075596 | Jiaochen Ke | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2019-04-19 |
| 1164913133 | Jason Singh Roley | General Practice | 225 37th Ave, San Mateo, CA 94403-4324 | 2018-05-24 |
| 1407353170 | Janet Baek | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2018-04-10 |
| 1710484456 | Kristoffer Calvert Strauss | General Practice | 222 West 39th Avenue, San Mateo, CA 94403 | 2018-04-10 |
| 1023514130 | Zachary Malcolm Lenane | General Practice | 225 37th Ave Fl 3, San Mateo, CA 94403-4324 | 2018-04-05 |
| 1467989061 | Arielle Lasky | General Practice | 222 W 39th Ave, San Mateo, CA 94403 | 2017-05-15 |
| 1306372834 | Michael Joel Lee | General Practice | 225 37th Ave, 3rd Floor, San Mateo, CA 94403-4324 | 2017-05-03 |
| 1922453513 | Clayton Barnes | General Practice | 225 37th Ave Fl 3, San Mateo, CA 94403-4324 | 2016-05-02 |
| 1760865950 | Armando Leon | General Practice | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2015-07-07 |
| Find all providers in SAN MATEO | ||||
Please comment or provide details below to improve the information on MILLS PENINSULA MEDICAL GROUP.
| 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.