SHADELANDS SURGERY CENTER, LLC (NPI# 1710012869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710012869 |
| Entity Type | Organization |
| Organization Name | SHADELANDS SURGERY CENTER, LLC |
| Practice Address |
100 N Wiget Ln Suite #110 Walnut Creek CA 94598-5988 |
| Practice Telephone | 9259337100 |
| Mailing Telephone | 9259337100 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-08-27 |
| Authorized Official Name | DR. BRADFORD TRUE PRESCOTT (MEMBER) |
| Authorized Official Telephone | 9259337100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
100 N WIGET LN SUITE #110 |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-5988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083698732 | Vahid Feiz | Ophthalmology | 100 N Wiget Ln, Suite 270, Walnut Creek, CA 94598-5988 | 2005-12-05 |
| 1669955837 | David Kevin Johnson | Psychologist | 100 N Wiget Ln, Walnut Creek, CA 94598-5988 | 2018-09-12 |
| 1699211565 | Vahid Feiz, Md, Inc | Ophthalmology | 100 N Wiget Ln, Suite 270, Walnut Creek, CA 94598-5988 | 2017-01-16 |
| 1598137416 | Seth Eberlin Md | Plastic Surgery | 100 N Wiget Ln, Ste 100, Walnut Creek, CA 94598-5988 | 2015-10-30 |
| 1245624212 | George James Counelis Md Inc | Neurological Surgery | 100 N Wiget Ln, Suite 160, Walnut Creek, CA 94598-5988 | 2015-03-26 |
| 1811295819 | Seth Eberlin | Plastic Surgery | 100 N Wiget Ln, Suite 100, Walnut Creek, CA 94598-5988 | 2011-03-01 |
| 1194048363 | Thomas L Clennell | Physical Therapist | 100 N Wiget Ln, Ste 200, Walnut Creek, CA 94598-5988 | 2010-03-02 |
| 1962686881 | Michelle Cappello | Physical Therapist | 100 N Wiget Ln, Suite 200, Walnut Creek, CA 94598-5988 | 2007-12-27 |
| 1407996358 | Bradford T. Prescott Medical Corporation | Plastic Surgery | 100 N Wiget Ln, Suite #100, Walnut Creek, CA 94598-5988 | 2007-02-08 |
| 1023041464 | Parminder Sethi | Urology | 100 N Wiget Ln, Ste 290, Walnut Creek, CA 94598-5988 | 2006-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770061459 | Walnut Creek Surgery Center LLC | Clinic/Center | 460 N Wiget Ln Ste C, Walnut Creek, CA 94598-2408 | 2018-08-03 |
| 1427585280 | Pinnacle Surgery Center, Inc | Clinic/Center | 100 N Wiget Ln Ste 140, Walnut Creek, CA 94598-5917 | 2017-05-11 |
| 1245620954 | Shadelands Endovascular, LLC | Clinic/Center | 460 N Wiget Ln Ste B, Walnut Creek, CA 94598-2408 | 2015-02-02 |
| 1609274505 | Bay Area Surgical Specialist Services, LLC | Clinic/Center | 460 N Wiget Ln, Walnut Creek, CA 94598-2408 | 2014-12-09 |
| 1851568067 | Walnut Creek Endoscopy Center LLC | Clinic/Center | 365 Lennon Ln Ste 100, Walnut Creek, CA 94598-5911 | 2008-05-15 |
| 1710177795 | Aspen Surgery Center, LLC | Clinic/Center | 133 La Casa Via, Walnut Creek, CA 94598 | 2007-07-26 |
| 1184798837 | Shadelands Advanced Endoscopy Institute, Inc. | Clinic/Center | 498 N Wiget Ln, Walnut Creek, CA 94598-2408 | 2006-11-17 |
| 1316939556 | Sequoia Surgical Center Lp | Clinic/Center | 2405 Shadelands Dr, Suite 200, Walnut Creek, CA 94598-2444 | 2005-08-15 |
| 1124658083 | Meridian Surgery Center, Inc | Clinic/Center | 100 N Wiget Ln Ste 140, Walnut Creek, CA 94598-5917 | 2020-01-20 |
| 1225361629 | William Jervis, M.d., F. A. C. S., Inc. | Clinic/Center | 1844 San Miguel Dr, Suite 109, Walnut Creek, CA 94596-4962 | 2009-09-16 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
Please comment or provide details below to improve the information on SHADELANDS SURGERY CENTER, LLC.
| 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.