MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC


Address: 5924 Stoneridge Drive, Suite 110, Pleasanton, CA 94588-5400
Phone: 9258466200

MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC (NPI# 1639282551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639282551
Entity Type Organization
Organization Name MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC
Practice Address 5924 Stoneridge Drive
Suite 110
Pleasanton
CA 94588-5400
Mailing Address 686 Mowry Ave
Fremont
CA 94536-4113
Practice Telephone 9258466200
Practice Fax Number 5107975184
Mailing Telephone 5107973933
Mailing Fax Number 5107975184
Enumeration Date 2006-08-16
Last Update Date 2012-10-18
Authorized Official Name LINGAGOUD MEMULA (ADMINISTRATOR)
Authorized Official Telephone 5108182011
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207X00000X Orthopaedic Surgery A657720 CA Allopathic & Osteopathic Physicians
N 208100000X Physical Medicine & Rehabilitation A81391 CA Allopathic & Osteopathic Physicians
N 208100000X Physical Medicine & Rehabilitation A95318 CA Allopathic & Osteopathic Physicians
N 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
A81391 CA Allopathic & Osteopathic Physicians
N 213ES0103X Podiatrist
Specialization: Foot & Ankle Surgery
E4711 CA Podiatric Medicine & Surgery Service Providers
N 363A00000X Physician Assistant PA17256 CA Physician Assistants & Advanced Practice Nursing Providers
N 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA17256 CA Physician Assistants & Advanced Practice Nursing Providers
Y 207X00000X Orthopaedic Surgery A698780 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA BLUE SHIELD ZZZ5427Z 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1609888593 Mission Peak Orthopaedic Medical Group, Inc Orthopaedic Surgery 39350 Civic Center Dr Ste 300, Fremont, CA 94538-2331 2006-08-12

Office Location

Street Address 5924 STONERIDGE DRIVE
SUITE 110
City PLEASANTON
State CA
Zip Code 94588-5400

Providers in the same zip code

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 Information

Taxonomy Code 207X00000X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1275632663 Donald W Rohren Orthopaedic Surgery 10 Bunker Ln, Pleasanton, CA 94566-9700 2006-09-21
1124082359 Lucille B. Andersen Orthopaedic Surgery 5924 Stoneridge Dr, Suite 103, Pleasanton, CA 94588-2887 2006-04-14
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

Competitor

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City PLEASANTON
Zip Code 94588

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Dataset Information

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.

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